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SYSTEMATIC REVIEW article

Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1383470

Correlation between thrombocytopenia and adverse outcomes in patients with atrial fibrillation: A systematic review and metaanalysis

Provisionally accepted
Qiuhua Ding Qiuhua Ding 1Wenlin Xu Wenlin Xu 1Yaoyao Chen Yaoyao Chen 1Sijie Chang Sijie Chang 1Jinhua Zhang Jinhua Zhang 2*
  • 1 Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China, Fuzhou, Fujian Province, China
  • 2 Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University , Fuzhou, China, Fuzhou, China

The final, formatted version of the article will be published soon.

    Background: Thrombocytopenia is often associated with adverse outcomes in patients with atrial fibrillation. Therefore，we conducted a meta-analysis to comprehensively assess the impact of thrombocytopenia on ischemic stroke/systemic embolism, major bleeding and all-cause mortality in patients with atrial fibrillation. Methods: Two electronic databases, PubMed and Web of Science, were systematically searched from their inception to December 1, 2023, including the studies on the correlation between atrial fibrillation patients with thrombocytopenia and adverse outcomes. Relevant data was extracted, literature quality was evaluated, meta-analysis was performed by using REVMAN 5.4 software, and the results were reported with odds ratio (OR) of 95% confidence interval (CI). PROSPERO registration number: CRD42023459916.Results: A total of 12 studies included 73824 patients with atrial fibrillation (average age: 72.67, males: 42,275, 57.3%), among them, there were 7673 patients combined with thrombocytopenia. The average follow-up time of these studies was 87 days to 55 months. Compared to no thrombocytopenia, atrial fibrillation patients combined with thrombocytopenia have a significant risk reduction of ischemic stroke/systemic embolism (OR: 0.79, 95% CI [0.69, 0.91]; P < 0.01). Nevertheless, the risk of both major bleeding (OR：1.51, 95% CI [1.20, 1.79], P < 0.01)and all-cause mortality (OR: 1.40, 95% CI [1.23, 1.61]; P < 0.01) is significantly higher in thrombocytopenia group.Conclusions: Thrombocytopenia has an important impact on the prognosis of patients with atrial fibrillation. Thrombocytopenia is significantly associated with a lower risk of ischemic stroke/systemic embolism but a higher risk of major bleeding and all-cause mortality. Attention to thrombocytopenia and optimization of treatment may be the effective way to improve the prognosis of atrial fibrillation with thrombocytopenia.

    Keywords: Atrial Fibrillation, Thrombocytopenia, Adverse outcomes, ischemic stroke/systemic embolism, Major bleeding, All-cause mortality

    Received: 18 Feb 2024; Accepted: 28 Oct 2024.

    Copyright: © 2024 Ding, Xu, Chen, Chang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jinhua Zhang, Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University , Fuzhou, China, Fuzhou, China

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