An insight into the Interplay between Immune Thrombocytopenic Purpura (ITP) and Heart Failure: A Retrospective Analysis of National Inpatient Data in the United States

Patients admitted with autoimmune thrombocytopenic purpura (ITP) are high-risk due to their susceptibility to bleeding and limitations on medical interventions. Heart failure (HF) is a widespread condition that significantly impairs quality of life, complicating the management of ITP. These patients often use blood thinners, exacerbating their risk profile. This study analyzed the National Inpatient Sample database for 2019-2020 to examine the impact of HF on ITP patients. The cohort included 27,885 patients hospitalized with ITP, of which 1,950 (7%) also had HF. Multivariate regression analysis was used to assess the outcomes. The results showed no significant difference in mortality (OR 1.1, 95% CI 0.52-2.29, P=0.795) and length of stay (+1.14 days, 95% CI 0.32-1.95, P=0.006) between the groups. However, hospitalization costs increased significantly for patients with HF (+17,762 USD, 95% CI 3,439-35,439, P=0.04). HF patients had higher odds of acute respiratory failure (OR 2.44, 95% CI 1.31-4.52, P=0.005), ICU admission (OR 1.86, 95% CI 1.015-3.41, P=0.044), and acute coronary syndrome (OR 6.27, 95% CI 1.05-37.47, P=0.04). No significant differences were found in major (OR 1, 95% CI 0.66-1.51, P=0.983) and minor bleeding (OR 1.36, 95% CI 0.33-5.58, P=0.666), blood transfusions (OR 0.81, 95% CI 0.52-1.25, P=0.352), platelet transfusions (OR 0.98, 95% CI 0.73-1.30, P=0.897), venous thromboembolism (OR 0.93, 95% CI 0.36-2.38, P=0.887), mechanical ventilation (OR 1.79, 95% CI 0.92-3.48, P=0.084), cardiac arrest (OR 3.04, 95% CI 0.65-14.11, P=0.156), acute kidney injury (OR 1.07, 95% CI 0.77-1.47, P=0.661), and sepsis (OR 1.61, 95% CI 0.59-4.39, P=0.346). In summary, HF in ITP patients is associated with higher hospitalization costs, increased acute respiratory failure, ICU admissions, and cardiac events, but not mortality or bleeding. Effective HF management in ITP patients is crucial for mitigating adverse outcomes and optimizing care.