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<p>Acute myocardial infarction (AMI) remains a major global health challenge with high mortality rates. This study investigated the association between platelet count and 30-day in-hospital mortality in critically ill AMI patients. This multicenter retrospective cohort study analyzed 6,850 critically ill AMI patients from 208 U.S. hospitals (2014–2015) using the eICU Collaborative Research Database v2.0. The primary exposure was baseline platelet count within 24&#xa0;h of ICU admission. The primary outcome was 30-day in-hospital mortality. Analyses were adjusted for demographics, laboratory parameters, disease severity, comorbidities, and treatments. A U-shaped relationship was identified between platelet count and mortality, with an inflection point at 147 × 10⁹/L. Below this threshold, each 10 × 10⁹/L increase in platelet count was associated with decreased mortality (OR = 0.931, 95% CI: 0.892–0.973, <i>P</i> = 0.001). Above the threshold, each 10 × 10⁹/L increase was associated with increased mortality (OR = 1.023, 95% CI: 1.010–1.036, <i>P</i> &lt; 0.001). A U-shaped relationship was observed between platelet count and 30-day in-hospital mortality in critically ill AMI patients, with optimal outcomes observed at approximately 147 × 10⁹/L, suggesting that platelet count may serve as a potential risk stratification marker.</p>

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Non-linear relationship between platelet count and 30-day in-hospital mortality in ICU patients with acute myocardial infarction: a multicenter retrospective cohort study

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  • 发表日期：

    2025年7月1日

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  • Tao Ling,
  • Pan Zhou,
  • Wei Liu,
  • Zhe Deng

摘要

Acute myocardial infarction (AMI) remains a major global health challenge with high mortality rates. This study investigated the association between platelet count and 30-day in-hospital mortality in critically ill AMI patients. This multicenter retrospective cohort study analyzed 6,850 critically ill AMI patients from 208 U.S. hospitals (2014–2015) using the eICU Collaborative Research Database v2.0. The primary exposure was baseline platelet count within 24 h of ICU admission. The primary outcome was 30-day in-hospital mortality. Analyses were adjusted for demographics, laboratory parameters, disease severity, comorbidities, and treatments. A U-shaped relationship was identified between platelet count and mortality, with an inflection point at 147 × 10⁹/L. Below this threshold, each 10 × 10⁹/L increase in platelet count was associated with decreased mortality (OR = 0.931, 95% CI: 0.892–0.973, P = 0.001). Above the threshold, each 10 × 10⁹/L increase was associated with increased mortality (OR = 1.023, 95% CI: 1.010–1.036, P < 0.001). A U-shaped relationship was observed between platelet count and 30-day in-hospital mortality in critically ill AMI patients, with optimal outcomes observed at approximately 147 × 10⁹/L, suggesting that platelet count may serve as a potential risk stratification marker.