Are Abnormal Pre-operative Platelet Counts a Risk Factor for Major Adverse Cardiovascular Events Following Non-cardiac Surgery?

Abstract

Background: We sought to determine whether abnormal pre-operative platelet counts are associated with increased major adverse cardiovascular events (MACE) in South African (SA) non-cardiac surgery settings. Methods: This was a propensity matched case-control study of data from 150 SA non-cardiac surgery patients. Patients had their data (age, gender, cardiovascular risk factors and pre-operative platelet counts) collected as part of a pre-existing registry. Cases were patients with post-operative MACE (post-operative stroke, myocardial infarction or all-cause mortality). Controls were patients without post-operative MACE. Data were analysed using conventional methods for matched case-control studies. Results: Our most important finding was that the odds of post-operative MACE were six-fold higher in patients with pre-operative thrombocytopenia (low platelet count) when compared to patients with normal pre-operative platelet counts (Odds Ratio, OR: 6.28, 95% Confidence Interval, CI: 1.19-33.12; p=0.031). Conclusion: Thrombocytopenia is a risk factor for post-operative MACE in SA non-cardiac surgery patients.

Keywords

• Platelets
• Non-cardiac surgery
• Cardiovascular complications
• South Africa