Thrombocytopaenia as a Prognostic Indicator in Heart Failure with Reduced Ejection Fraction

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• 作者：Mohammad Khalid Mojadidi ; MD ; ^{mkmojadidi@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Jose Nahun Galeas ; MD ; David Goodman-Meza ; MD ; Parham Eshtehardi ; MD ; FAHA ; Pavlos Msaouel ; MD ; PhD ; Iosif Kelesidis ; MD ; Muhammad Omer Zaman ; MD ; Jared S. Winoker ; MD ; Scott C. Roberts ; MD ; Panagiota Christia ; MD ; Ronald Zolty ; MD ; FACC
• 关键词：HF ; heart failure ; HFrEF ; heart failure with reduced ejection fraction ; LVEF ; left ventricular ejection fraction ; EF ; ejection fraction
• 刊名：Heart, Lung and Circulation
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：25
• 期：6
• 页码：568-575
• 全文大小：475 K

文摘

Studies suggest that thrombocytopaenia is associated with a higher mortality in several diseases. Little is known about the effect of low platelet count on mortality in patients with heart failure with reduced ejection fraction (HFrEF). The aim of this study was to determine the prognostic value of thrombocytopaenia in these patients by assessing all-cause mortality.

Methods

A total of 1,907 patients with HFrEF, defined by left ventricular ejection fraction <40% on echocardiography, were analysed in this multi-centre retrospective study. All patients were on medical therapy with a beta-blocker and an angiotensin-converting enzyme inhibitor. Patients were categorised into two groups based on platelet count measured within one month of the diagnosis of HFrEF: normal to mild thrombocytopaenia (platelet count 100,000-450,000 per uL); and moderate to severe thrombocytopaenia (platelet count <100,000 per uL). One-year all-cause mortality was compared between the two groups.

Results

Mean age was 65±15 years and 62% of patients were male. Overall one-year mortality was 17.2% with higher mortality among patients with HFrEF and moderate/severe thrombocytopaenia compared to those with normal/mild thrombocytopaenia (33.0% vs. 15.4%, p <0.001). After adjusting for baseline characteristics, patients with HFrEF and moderate/severe thrombocytopaenia had a higher mortality compared to patients with normal/mild thrombocytopaenia (HR 1.84, 95% CI 1.33-2.56, p <0.001).

Conclusion

In patients with HFrEF, higher degree of thrombocytopaenia is associated with higher all-cause mortality. These findings may support the use of platelet counts as a prognostic marker in the assessment of the patient with HFrEF.