The following is a summary of “Inpatient outcomes of NSTEMI among patients with immune thrombocytopenia: a propensity matched national study,” published in the August 2024 issue of Hematology by Baig et al.

Patients with immune thrombocytopenia (ITP) and non-ST elevation myocardial infarction (NSTEMI) face a complex treatment dilemma due to heightened bleeding risk from standard therapies, with limited data on outcomes.

Researchers conducted a retrospective study analyzing hospital mortality and complications in NSTEMI patients with ITP compared to those without ITP using data from the National Inpatient Sample database.

They used a patient cohort from the 2018–2021 National Inpatient Sample database, matched NSTEMI patients with and without ITP using propensity scores in a 1:1 ratio, and analyzed various outcomes, including in-hospital mortality, diagnostic angiogram rates, percutaneous coronary intervention (PCI), acute kidney injury (AKI), congestive heart failure (CHF), cardiogenic shock, cardiac arrest, mechanical ventilation, tracheal intubation, ventricular tachycardia (VT), ventricular fibrillation (VF), major bleeding, need for blood and platelet transfusion, length of stay (LOS), major bleeding, blood and platelet transfusion needs, and hospitalization charges.

The results showed 1,699,020 patients (660,490 females [39%], predominantly Caucasian 1,198,415 [70.5%]; mean [SD] age 67 [3.1]), including 2,615 (0.1%) with ITP, 1,020 NSTEMI patients with and without ITP were matched. Patients with ITP experienced higher inpatient mortality (aOR 1.98, 95% CI 1.11–3.50, P 0.02), as well as increased rates of cardiogenic shock, AKI, mechanical ventilation, tracheal intubation, red blood cell, and platelet transfusions, longer LOS, and higher hospitalization charges. The groups had similar rates of diagnostic angiogram, PCI, CHF, VT, VF, and major bleeding.

Investigators conclude that NSTEMI patients with ITP have higher odds of in-hospital mortality and a greater need for platelet transfusion compared to those without ITP. There was no difference in diagnostic angiogram or PCI rates between the 2 groups.

Source: link.springer.com/article/10.1007/s00277-024-05913-7