Alexander Dutsch, Christian Graesser, Sophie Novacek, Johannes Krefting, Viktoria Schories, Benedikt Niedermeier, Felix Voll, Sebastian Kufner, Erion Xhepa, Michael Joner, Salvatore Cassese, Heribert Schunkert, Gjin Ndrepepa, Adnan Kastrati, Thorsten Kessler, Hendrik B Sager
{"title":"基线血小板计数可预测急性心肌梗死后的梗死面积和死亡率","authors":"Alexander Dutsch, Christian Graesser, Sophie Novacek, Johannes Krefting, Viktoria Schories, Benedikt Niedermeier, Felix Voll, Sebastian Kufner, Erion Xhepa, Michael Joner, Salvatore Cassese, Heribert Schunkert, Gjin Ndrepepa, Adnan Kastrati, Thorsten Kessler, Hendrik B Sager","doi":"10.1055/a-2299-0130","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong> Platelets greatly contribute to cardiovascular diseases. We sought to explore the association of platelet counts with infarct size and outcome in patients presenting with acute ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention (PPCI).</p><p><strong>Methods and results: </strong> In this retrospective study, we grouped 1,198 STEMI patients into tertiles (T) based on platelet count on admission: T1 = 102-206 [10<sup>9</sup> platelets/L] (<i>n</i> = 402), T2 = 207-259 [10<sup>9</sup> platelets/L] (<i>n</i> = 396), and T3 = 260-921 [10<sup>9</sup> platelets/L] (<i>n</i> = 400). Primary endpoint was 1-year all-cause mortality. Patients with highest platelet counts on admission showed the greatest area at risk and infarct size: area at risk (median) was 22.0% (interquartile range [IQR]: 12.0-39.8%) in T1, 21.0% (IQR: 11.0-37.1%) in T2, and 26.0% (IQR: 14.9-45.0%) of the left ventricle in T3 (<i>p</i> = 0.003); final infarct sizes after 7 to 14 days were as follows: 10.0% (IQR: 2.0-21.0%) in T1, 9.0% (IQR: 2.0-20.7%) in T2, and 12.0% (IQR: 3.0-27.3%) of the left ventricle in T3 (<i>p</i> = 0.015) as serial imaging revealed. At 1 year, 16 all-cause deaths occurred in T1, 5 in T2, and 22 in T3 (log-rank test, <i>p</i> = 0.006). After adjustment, T1 and T3 were associated with all-cause 1-year mortality (T1: hazard ratio [HR] = 3.40, 95% confidence interval [CI] = 1.23-9.54, <i>p</i> = 0.02; T3: HR = 3.55, 95% CI = 1.23-9.78, <i>p</i> = 0.01) compared with T2. At 5 years, all-cause mortality remained numerically higher in the T1 and T3.</p><p><strong>Conclusions: </strong> In patients with STEMI undergoing PPCI, low and high blood platelet levels on admission were associated with increased long-term mortality (Fig. 1).</p>","PeriodicalId":55074,"journal":{"name":"Hamostaseologie","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Baseline Platelet Count Predicts Infarct Size and Mortality after Acute Myocardial Infarction.\",\"authors\":\"Alexander Dutsch, Christian Graesser, Sophie Novacek, Johannes Krefting, Viktoria Schories, Benedikt Niedermeier, Felix Voll, Sebastian Kufner, Erion Xhepa, Michael Joner, Salvatore Cassese, Heribert Schunkert, Gjin Ndrepepa, Adnan Kastrati, Thorsten Kessler, Hendrik B Sager\",\"doi\":\"10.1055/a-2299-0130\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong> Platelets greatly contribute to cardiovascular diseases. We sought to explore the association of platelet counts with infarct size and outcome in patients presenting with acute ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention (PPCI).</p><p><strong>Methods and results: </strong> In this retrospective study, we grouped 1,198 STEMI patients into tertiles (T) based on platelet count on admission: T1 = 102-206 [10<sup>9</sup> platelets/L] (<i>n</i> = 402), T2 = 207-259 [10<sup>9</sup> platelets/L] (<i>n</i> = 396), and T3 = 260-921 [10<sup>9</sup> platelets/L] (<i>n</i> = 400). Primary endpoint was 1-year all-cause mortality. Patients with highest platelet counts on admission showed the greatest area at risk and infarct size: area at risk (median) was 22.0% (interquartile range [IQR]: 12.0-39.8%) in T1, 21.0% (IQR: 11.0-37.1%) in T2, and 26.0% (IQR: 14.9-45.0%) of the left ventricle in T3 (<i>p</i> = 0.003); final infarct sizes after 7 to 14 days were as follows: 10.0% (IQR: 2.0-21.0%) in T1, 9.0% (IQR: 2.0-20.7%) in T2, and 12.0% (IQR: 3.0-27.3%) of the left ventricle in T3 (<i>p</i> = 0.015) as serial imaging revealed. At 1 year, 16 all-cause deaths occurred in T1, 5 in T2, and 22 in T3 (log-rank test, <i>p</i> = 0.006). After adjustment, T1 and T3 were associated with all-cause 1-year mortality (T1: hazard ratio [HR] = 3.40, 95% confidence interval [CI] = 1.23-9.54, <i>p</i> = 0.02; T3: HR = 3.55, 95% CI = 1.23-9.78, <i>p</i> = 0.01) compared with T2. At 5 years, all-cause mortality remained numerically higher in the T1 and T3.</p><p><strong>Conclusions: </strong> In patients with STEMI undergoing PPCI, low and high blood platelet levels on admission were associated with increased long-term mortality (Fig. 1).</p>\",\"PeriodicalId\":55074,\"journal\":{\"name\":\"Hamostaseologie\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-10-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hamostaseologie\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2299-0130\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hamostaseologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2299-0130","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Baseline Platelet Count Predicts Infarct Size and Mortality after Acute Myocardial Infarction.
Introduction: Platelets greatly contribute to cardiovascular diseases. We sought to explore the association of platelet counts with infarct size and outcome in patients presenting with acute ST-segment elevation MI (STEMI) treated with primary percutaneous coronary intervention (PPCI).
Methods and results: In this retrospective study, we grouped 1,198 STEMI patients into tertiles (T) based on platelet count on admission: T1 = 102-206 [109 platelets/L] (n = 402), T2 = 207-259 [109 platelets/L] (n = 396), and T3 = 260-921 [109 platelets/L] (n = 400). Primary endpoint was 1-year all-cause mortality. Patients with highest platelet counts on admission showed the greatest area at risk and infarct size: area at risk (median) was 22.0% (interquartile range [IQR]: 12.0-39.8%) in T1, 21.0% (IQR: 11.0-37.1%) in T2, and 26.0% (IQR: 14.9-45.0%) of the left ventricle in T3 (p = 0.003); final infarct sizes after 7 to 14 days were as follows: 10.0% (IQR: 2.0-21.0%) in T1, 9.0% (IQR: 2.0-20.7%) in T2, and 12.0% (IQR: 3.0-27.3%) of the left ventricle in T3 (p = 0.015) as serial imaging revealed. At 1 year, 16 all-cause deaths occurred in T1, 5 in T2, and 22 in T3 (log-rank test, p = 0.006). After adjustment, T1 and T3 were associated with all-cause 1-year mortality (T1: hazard ratio [HR] = 3.40, 95% confidence interval [CI] = 1.23-9.54, p = 0.02; T3: HR = 3.55, 95% CI = 1.23-9.78, p = 0.01) compared with T2. At 5 years, all-cause mortality remained numerically higher in the T1 and T3.
Conclusions: In patients with STEMI undergoing PPCI, low and high blood platelet levels on admission were associated with increased long-term mortality (Fig. 1).
期刊介绍：
Hämostaseologie is an interdisciplinary specialist journal on the complex topics of haemorrhages and thromboembolism and is aimed not only at haematologists, but also at a wide range of specialists from clinic and practice. The readership consequently includes both specialists for internal medicine as well as for surgical diseases.
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