Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome.

PURPOSE: To evaluate the predictive value of a bedside index in hospitalized patients with acute coronary syndromes (ACS). METHODS: We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the response to antiplatelet therapy, measured by light transmission aggregometry. RESULTS: In the derivation cohort we included 1100 patients with non STEM-ACS, GRACE score of 133 ± 52, Crusade score 24,3 ± 14, 66% male, 65 + 11 years. LPI was 17 (12-24). LPI was higher (19 (13-25)) in patients with MI than in patients with unstable angina (16 (12-22) in (p < 0.001)). A total of 115 patients (10.5%) had the CEP. CEP was associated to LPI (OR 1.04 (1.002-1.08), p = 0.03), age (OR 1.01 (0.97-1.05), p = 0.62) and GRACE>140 (OR 8.1 (2.2-29), p = 0.02). LPI (OR 1.04 (1.004-1.07) p = 0.03) and GRACE score (OR 1.02 (1.01-1.03) p < 0.01) were associated to cardiovascular mortality. We confirmed these results in the validation cohort #1 (686 patients, 61 + 11 years old, 47% nonST-ACS, 53% ST-ACS, 21% had CEP) and in validation cohort #2 (218 patients, 56.8% males, 73 + 7 years old, 79% nonST-ACS, GRACE score 136 + 30) and 8.3% with CEP. We used the cutoff points of LPI obtained in the derivation cohort (>24). CONCLUSIONS: LPI > 24 was associated to CEP (OR (1.7-5.2), p 0.01), independently of age (OR 1 (0.98-1.02), p = 0.8), and GRACE score (OR 1.01 (0.99-1.01), p 0.69), and It was associated to antiplatelet resistance (OR 1.03 (95% CI 1.00-1.06) p = 0.05).

Un caso exitoso de trasplante bipulmonar durante la pandemia por SARS CoV-2 en la Ciudad de Buenos Aires / A Successful Case of Double-Lung Transplant During the SARS CoV-2 Pandemic in the City of Buenos Aires

Paciente masculino portador de hipertesión pulmonar severa refractaria a tratamiento médico, sometido a trasplante bipulmonar durante la pandemia por SARS-CoV-2 en la ciudad de Buenos Aires. Para disminuir el riesgo de contagio se realizaron todas las medidas de prevención actualmente recomendadas, con especial énfasis en el uso del equipo de protección personal, contribuyendo de esta forma con el éxito terapéutico alcanzado.

Male patient with severe pulmonary hypertension refractory to medical treatment who underwent a double-lung transplant during the SARS-CoV-2 in the city of Buenos Aires. In order to reduce the risk of contagion all the currently recommended prevention measures were adopted, especially the use of personal protective equipment, thus contributing to the resultant therapeutic success.