Thromb Haemost 2013; 110(05): 1025-1034
DOI: 10.1160/TH13-04-0352
Platelets and Blood Cells
Schattauer GmbH

Platelet count and outcome in patients with acute venous thromboembolism

Pierpaolo Di Micco
1   Department of Internal Medicine, Ospedale Buonconsiglio Fatebenefratelli, Naples, Italy
,
Nuria Ruiz-Giménez
2   Department of Internal Medicine, Hospital La Princesa, Madrid, Spain
,
José Antonio Nieto
3   Department of Internal Medicine, Hospital Virgen de la Luz, Cuenca, Spain
,
Drahomir Aujesky
4   Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
,
Fátima del Molino
5   Department of Internal Medicine, Hospital General de Catalunya, Barcelona, Spain
,
Reina Valle
6   Department of Internal Medicine, Hospital de Sierrallana, Santander, Cantabria, Spain
,
Manuel Barrón
7   Department of Pneumonology, Complejo Hospitalario San Millán y San Pedro, Logroño, La Rioja, Spain
,
Ana Maestre
8   Department of Internal Medicine, Hospital Vinalopó Salud, Alicante, Spain
,
Manuel Monreal
9   Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
the RIETE Investigators› Author Affiliations
Further Information

Publication History

Received: 29 April 2013

Accepted after major revision: 06 July 2013

Publication Date:
01 December 2017 (online)

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Summary

The relationship between platelet count and outcome in patients with acute venous thromboembolism (VTE) has not been consistently explored. RIETE is an ongoing registry of consecutive patients with acute VTE. We categorised patients as having very low- (<80,000/μl), low- (80,000/μl to 150,000/μl), normal- (150,000/μl to 300,000/μl), high- (300,000/μl to 450,000/μl), or very high (>450,000/μl) platelet count at baseline, and compared their three-month outcome. As of October 2012, 43,078 patients had been enrolled in RIETE: 21,319 presenting with pulmonary embolism and 21,759 with deep-vein thrombosis. In all, 502 patients (1.2%) had very low-; 5,472 (13%) low-; 28,386 (66%) normal-; 7,157 (17%) high-; and 1,561 (3.6%) very high platelet count. During the three-month study period, the recurrence rate was: 2.8%, 2.2%, 1.8%, 2.1% and 2.2%, respectively; the rate of major bleeding: 5.8%, 2.6%, 1.7%, 2.3% and 4.6%, respectively; the rate of fatal bleeding: 2.0%, 0.9%, 0.3%, 0.5% and 1.2%, respectively; and the mortality rate: 29%, 11%, 6.5%, 8.8% and 14%, respectively. On multivariate analysis, patients with very low-, low-, high- or very high platelet count had an increased risk for major bleeding (odds ratio [OR]: 2.70, 95% confidence interval [CI]: 1.85–3.95; 1.43 [1.18–1.72]; 1.23 [1.03–1.47]; and 2.13 [1.65–2.75]) and fatal bleeding (OR: 3.70 [1.92–7.16], 2.10 [1.48–2.97], 1.29 [0.88–1.90] and 2.49 [1.49–4.15]) compared with those with normal count. In conclusion, we found a U-shaped relationship between platelet count and the three-month rate of major bleeding and fatal bleeding in patients with VTE.

* A full list of the RIETE investigators is given in the Appendix.