Cardiovascular Manifestations in Patients With Thrombotic Thrombocytopenic Purpura: A Single-center Experience

Background: Cardiovascular manifestation in patients with thrombotic thrombocytopenic purpura. Hypothesis: The aim of this study was to investigate the incidence of acute myocardial infarction (AMI), arrhythmias, congestive heart failure, and mortality in patients hospitalized for thrombotic thrombocytopenic purpura (TIP). Methods: Thirty-eight patients (27 women and 11 men), mean age 44 years, were hospitalized with the diagnosis of TIP confirmed by a hematologist. We investigated the incidence of AMI which developed during hospitalization for TIP. AMI was diagnosed by new electrocardiographic changes, increased serum cardiac troponin I levels, and clinical symptomatology. The patients with AMI were also monitored for development of arrhythmias during hospitalization. Results: Of the 38 patients, 8 (21%) developed new Q-wave AMI. There was no significant difference in baseline characteristics between patients who developed AMI and those who did not develop AMI. Of the 8 patients with AMI, 2 (25%) developed atrial fibrillation, 1 (13%) developed atrial flutter, 1 (13%) developed supraventricular tachycardia, and 2 (25%) developed congestive heart failure. Death occurred in 3 of 8 patients (38%) with AMI and in 1 of 30 patients (3%) without AMI (P < 0.01). Conclusions: New Q-wave AMI developed in 21% of 38 patients hospitalized with TIP. Supraventricular tachyarrhythmias developed in 50% of 8 patients with TIP who developed AMI. Patients hospitalized for TIP should be monitored for adverse cardiac events due to the high incidence of new AMI, supraventricular tachyarrhythmias, and mortality.