[01] Muhammad Irfan, Medicine department, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan. [02] Ghulam Mustafa Aftab, Medical Student, CMH Medical College, Lahore, Pakistan. [03] Muhammad Arif Nadeem, Medicine department, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan. [04] Irfan Bhatti, Medicine department, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan. [05] Tariq Suleman, Medicine department, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan. [06] Khalil Ahmed, Medicine department, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan. [07] Muhammad Naseem Akhtar, Medicine department, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan. [08] Attique Abou Bakr, Medicine department, Services Institute of Medical Sciences, Services Hospital, Lahore, Pakistan.

Objective: To determine characteristics of Ischemic Heart Disease (IHD) patients dying with drug induced bone marrow suppression. Study Design: Cross-sectional Study. Place and Duration of Study: Medical Unit 3, Services Hospital Lahore, from December 2011 to February 2012. Methodology: Patients of IHD taking medication from Punjab Institute of Cardiology (PIC), Lahore presented with mucosal bleeding (PIC syndrome). The clinical data and laboratory assessment was made, analyzed and Fisher exact test applied to find any significance at 5% level. Results: Amongst 86 patients with Platelet count <100,000/mm3, 25.6% patients died while 74.4% discharged. Death group of patients had statistically significant association with Fever (p = 0.002), Diabetes Mellitus (p = 0.002), abnormal ALT (p = 0.000) and abnormal serum creatinine (p = 0.026), while recovered group had significant association with current no use of clopidogrel (p = 0.000), calcium channel blockers (p = 0.000) and nitrates (p = 0.017). However, gender, age, bleeding, past history of Dengue, Hemoglobin, White cell count, Platelet count, INR, current use of aspirin, beta-blockers, ACE inhibitors and statins had no significance with hospitalization outcome. The risk of bleeding was >4.115 times in patients using calcium channel blockers. Conclusion: A large number of IHD patient had died during the epidemic of drug induced bone marrow suppression and death was common among patients with diabetes, fever, abnormal ALT and abnormal creatinine. However recovery was more among patients not using clopidogrel, calcium channel blockers and nitrates. The risk of bleeding was positively correlated with use of calcium channel blockers.

Ischemic Heart Disease, PIC Syndrome, Bone Marrow Suppression, Death

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