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Adverse Events with Platelet Drop in Coronary Syndromes

Thrombocytopenia increases risk of outcomes such as death or heart attack

WEDNESDAY, Dec. 26 (HealthDay News) -- Patients with non-ST-elevation acute coronary syndromes have a higher risk of adverse outcomes such as death or heart attack if they develop thrombocytopenia, according to the results of a study in the Dec. 15 issue of the American Journal of Cardiology.

Robert W. Yeh, M.D., from the University of California San Francisco, and colleagues examined the incidence and clinical importance of thrombocytopenia in 3,910 patients with non-ST-elevation acute coronary syndromes who were randomly assigned to enoxaparin or unfractionated heparin. Thrombocytopenia was defined as fewer than 100 billion platelets per liter or a greater than 50 percent drop in platelets from baseline.

The researchers found that 93 patients developed thrombocytopenia after 14 days, with a similar incidence in both groups. The risk of death, non-fatal myocardial infarction, and urgent revascularization was significantly higher in patients with thrombocytopenia (odds ratio 2.96), regardless of treatment. The risk of major bleeding was also higher, regardless of treatment.

"In conclusion, thrombocytopenia is a significant correlate of adverse events in patients presenting with non-ST-elevation acute coronary syndromes treated with either enoxaparin or unfractionated heparin," Yeh and colleagues conclude.

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