Concurrent coronary artery disease and immune thrombocytopenia: a systematic review

Frontiers in Medicine

Medicine

Drew Provan¹  Khaled Shunnar²  Mahmoud Marashi³  Mona AlRasheed⁴  Mohamed Yassin⁵  Murtadha Al-Khabori⁶  Hani Osman⁷  Ashraf Omer Ahmed⁸  Waail Rozi⁸  Mostafa Najim⁹  Alaa Rahhal^1,10 

[1] Barts and The London School of Medicine, Queen Mary University of London, London, United Kingdom;Cardiology Department, Hamad Medical Corporation, Doha, Qatar;Dubai Academic Health Corporation and Mediclinic Hospital, Dubai, United Arab Emirates;Hematology Department, AlAdan Hospital, Hadiya, Kuwait;Hematology Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar;Hematology Department, Sultan Qaboos University, Muscat, Oman;Hematology and Oncology Department, Tawam Hospital, Abu-Dhabi, United Arab Emirates;Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar;Internal Medicine Department, Rochester Regional Health—Unity Hospital, New York, NY, United States;Pharmacy Department, Hamad Medical Corporation, Doha, Qatar;

关键词: coronary artery disease;    acute coronary syndrome;    immune thrombocytopenia;    intravenous immunoglobulins;    percutaneous coronary intervention;    coronary artery bypass graft surgery;   

DOI  :  10.3389/fmed.2023.1213275

 received in 2023-04-27, accepted in 2023-09-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionCoronary artery disease (CAD) management in the setting of immune thrombocytopenia (ITP) remains very challenging to clinicians as a reasonable balance between bleeding and thrombosis risks needs to be achieved, and the evidence guiding such management is scarce.MethodsWe conducted a systematic review following the PRISMA guidelines to summarize the available literature on the management and outcomes of CAD coexisting with ITP. We searched PubMed and Embase for studies published in English exploring CAD and ITP management until 05 October 2022. Two independent reviewers screened and assessed the articles for inclusion. Patients' characteristics, CAD treatment modalities, ITP treatment, and complications were reported.ResultsWe identified 32 CAD cases, among which 18 cases were revascularized with percutaneous coronary intervention (PCI), 12 cases underwent coronary artery bypass graft surgery (CABG), and two cases were managed conservatively. More than 50% were men, with a mean age of 61 ± 13 years and a mean baseline platelet count of 52 ± 59 × 109/L. Irrespective of the revascularization modality, most patients were treated with either corticosteroids alone, intravenous immunoglobulins (IVIG) alone, or in combination. Among those who underwent PCI, two patients had bleeding events, and one patient died. Similarly, among those with CABG, one patient developed bleeding, and one patient died.ConclusionWe found that revascularization with either PCI or CABG with the concurrent use of corticosteroids and/or IVIG for ITP was feasible, with an existing non-negligible risk of bleeding and mortality.

【 授权许可】

Unknown   
Copyright © 2023 Rahhal, Provan, Shunnar, Najim, Ahmed, Rozi, Al-Khabori, Marashi, AlRasheed, Osman and Yassin.