Abstract Number: VPB0329
Meeting: ISTH 2022 Congress
Background: Heparin-induced thrombocytopenia (HIT) is a well-established, devastating complication for patients undergoing cardiac surgery. However, there is no data comparing the risk of HIT between percutaneous cardiac intervention (PCI) and coronary artery bypass graft surgery (CABG).
Aims: We sought to determine the impact of the procedure modality (PCI vs CABG) on the development and outcomes of HIT.
Methods: We conducted a retrospective analysis of the 2016 to 2018 Nationwide Inpatient Sample. Adult patients undergoing PCI or CABG (age ≥18) were selected using the ICD-10 procedure and diagnosis codes. Discharge-level weight analysis was used to produce a national estimate. Propensity score matching (1:1) with age, female and comorbidity burden was performed and outcomes were compared between matched cohorts.
Results: During the study period, 2,008,294 patients were admitted for PCI (70.8%) or CABG (29.2%). PCI patients tended to be younger (65.2 SE 0.02 vs 66.2 SE 0.03) and female (33.0% vs 25.0%) with lower proportion of chronic kidney disease (10.2% vs 11.2%). The overall incidence of HIT was 0.19%. In a propensity matched cohort, PCI was associated with lower risk of HIT (OR 0.99; 0.99-0.99; p = 0.001). Among those who developed HIT, PCI decreased the risk for deep vein thrombosis (OR 0.91; 0.86-0.96; p = 0.001), pulmonary embolism (OR 0.95; 0.92-0.98; p=0.003) and acute kidney injury (OR 0.89; 0.82-0.96; p = 0.003). When we limited it to patients who underwent three-vessel PCI or CABG, PCI still decreased the risk of HIT (OR 0.99; 0.99-0.99; p = 0.001). There was no significant difference in HIT related in-hospital mortality in both groups (p = 0.8).
Conclusion(s): Incidence of HIT was extremely low in patients undergoing cardiac procedure. CABG was associated with higher risk for development of HIT and HIT/Thrombosis and acute kidney injury when it compared to PCI. Further studies are needed to investigate procedure-related risk for HIT.
To cite this abstract in AMA style:Park K, Aung P. Propensity Matched Comparison of Incidence and Outcomes of Heparin-Induce Thrombocytopenia in Patients Undergoing Percutaneous Cardiac Intervention vs Coronary Artery Bypass Grafting [abstract]. https://abstracts.isth.org/abstract/propensity-matched-comparison-of-incidence-and-outcomes-of-heparin-induce-thrombocytopenia-in-patients-undergoing-percutaneous-cardiac-intervention-vs-coronary-artery-bypass-grafting/. Accessed September 22, 2023.
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