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Acute thrombocytopenia associated with eptifibatide therapy
Yaariv Khaykin1, Fran L Paradiso-Hardy, Mina Madan
1Division of Cardiology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
The Canadian Journal of Cardiology
|June 19, 2003
Summary
Thrombocytopenia, a serious complication of platelet glycoprotein (GP) IIb/IIIa inhibitor therapy, occurred in 1.3% of patients receiving eptifibatide. Close platelet count monitoring after initiating eptifibatide can prevent adverse events.
Area of Science:
- Cardiology
- Pharmacology
- Hematology
Background:
- Platelet glycoprotein (GP) IIb/IIIa receptor blockade is crucial for managing percutaneous coronary interventions and acute coronary syndromes.
- Thrombocytopenia is a known complication of abciximab, a prototype GPIIb/IIIa inhibitor, but its occurrence with other agents is less emphasized.
Observation:
- This study aimed to determine the incidence of thrombocytopenia in patients treated with eptifibatide at a tertiary cardiac center.
- A chart review of 305 consecutive patients treated with eptifibatide was conducted.
Findings:
- Four patients (1.3%) developed acute thrombocytopenia (platelet count < 100 x 10(9)/L) within 6 hours of eptifibatide administration.
- Platelet counts recovered within 6 to 30 hours after discontinuing eptifibatide, with no related adverse clinical events.
- One patient had prior eptifibatide exposure; the other three cases are detailed.
Implications:
- Close monitoring of platelet counts is essential for all GPIIb/IIIa inhibitors, including eptifibatide.
- Monitoring at 2-6 hours and 24 hours post-initiation can detect most acute thrombocytopenia cases.
- Prompt discontinuation of GPIIb/IIIa inhibitors can prevent adverse events associated with thrombocytopenia.