Thrombocytopenia is an independent predictor of mortality in pulmonary hypertension

Mohammad Khalid Mojadidi, David Goodman-Meza, Parham Eshtehardi, Mohan Pamerla, Pavlos Msaouel, Scott C. Roberts, Jared S. Winoker, Neville M. Jadeja, Ronald Zolty

Research output: Contribution to journalArticle

Abstract

Background: Established prognostic factors for pulmonary hypertension (PH) include brain natriuretic peptide, troponins and hemodynamic measures such as central venous pressure and cardiac output. The prognostic role of thrombocytopenia, however, has yet to be determined in patients with PH. The aim of this study was to evaluate effect of thrombocytopenia on mortality in patients with PH. Methods: 521 patients with severe PH, defined by a pulmonary artery systolic pressure 60mmHg on transthoracic echocardiography and a platelet count measured within one month after diagnosis were enrolled from three hospitals of Montefiore Medical Center. The cohort was divided into two groups: mild thrombocytopenia to a normal platelet count (platelet count 100,000-450,000 per uL); and moderate to severe thrombocytopenia (platelet count <100,000 per uL). Inpatient and social security death records were used to determine 1-year all-cause mortality. Results: Mean age was 70.3±15.6 with 40% of patients being male. Overall mortality at 1 year was 30.7%, with increased mortality in PH patients with mild thrombocytopenia compared to those with moderate to severe thrombocytopenia (46.5% vs. 27.0%, p<0.001). In multivariate analysis, moderate to severe thrombocytopenia remained an independent predictor of mortality (HR 1.798, 95% CI 1.240-2.607, p=0.002). Conclusions: Moderate to severe thrombocytopenia is an independent predictor of higher mortality in patients with severe PH. These findings may support the use of thrombocytopenia as a useful prognostic indicator in patients with severe PH.

Original languageEnglish (US)
Pages (from-to)569-573
Number of pages5
JournalHeart and Lung: Journal of Acute and Critical Care
Volume43
Issue number6
DOIs
StatePublished - Jan 1 2014

Keywords

  • ACEi
  • LVEF
  • Mortality
  • PASP
  • PH
  • Platelets
  • Pulmonary hypertension
  • Thrombocytopenia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Mojadidi, M. K., Goodman-Meza, D., Eshtehardi, P., Pamerla, M., Msaouel, P., Roberts, S. C., Winoker, J. S., Jadeja, N. M., & Zolty, R. (2014). Thrombocytopenia is an independent predictor of mortality in pulmonary hypertension. Heart and Lung: Journal of Acute and Critical Care, 43(6), 569-573. https://doi.org/10.1016/j.hrtlng.2014.07.006