Acute Serious Thrombocytopenia Associated with Intracoronary Tirofiban Use for Primary Angioplasty

Yurtdaş, Mustafa; Yaylali, Yalın Tolga; Aladağ, Nesim; Özdemir, Mahmut; Atay, Memiş Hilmi

doi:10.1155/2014/190149

Cited by 10 publications

(12 citation statements)

References 10 publications

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“…Thrombocytopenia is a prominent complication of GPIs with an incidence of severe thrombocytopenia (platelet count <50 k/mm 3 ) to be 0.2-0.5% [1,3,5,8].…”

Section: Discussionmentioning

confidence: 99%

“…Five different presentations of GPI-induced thrombocytopenia have been reported: (i) Acute Severe Thrombocytopenia (platelets <10 k/mm 3 ) within 12 h of first dose administration, (ii) Acute Thrombocytopenia within 12 h of second dose administration, (iii) Delayed Thrombocytopenia (5-7 days after exposure), (iv) Anaphylaxis after first or second exposure, and (v) Pseudo thrombocytopenia [1,3].…”

Section: Discussionmentioning

confidence: 99%

“…In the subsequent days, as the patient's platelets count recovered, aspirin and plavix were restarted. Her platelets continued to improve, and the patient was discharged with a platelet count of 114 k/mm 3 . After a week, repeat laboratory work revealed an improved platelet count to 442 k/mm 3 .…”

Section: Case Presentationmentioning

confidence: 95%

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Tirofiban Induced Thrombocytopenia: A Rare but Severe Adverse Effect

Rawala

Ahmed

Posina

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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With the advent of medical technology, coronary angiography is a common practice to evaluate patient for coronary artery disease. Normally, patients undergoing angiogram receive antiplatelets, anticoagulants, and platelet aggregation inhibitor agents. Glycoprotein IIb/IIIa receptor inhibitors are a type of platelets antiaggregant agents that can cause severe thrombocytopenia in very few cases. We present a case of a 69-year-old female who presented with chest pain, underwent an angiography and had two stents placed. She was administered tirofiban during angiogram that caused acute severe thrombocytopenia decreasing her platelets count from 224 to 2 k/mm 3 within 1 day. Patients platelets gradually recovered after trial of steroid and platelets transfusion. Antiplatelets (Aspirin and Clopidogrel) were resumed; however, patient's platelets remained stable.

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“…Thrombocytopenia is a prominent complication of GPIs with an incidence of severe thrombocytopenia (platelet count <50 k/mm 3 ) to be 0.2-0.5% [1,3,5,8].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tirofiban Induced Thrombocytopenia: A Rare but Severe Adverse Effect

Rawala

Ahmed

Posina

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

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“…Immune thrombocytopenia occurring as a response to GP IIb/IIIa inhibitors is well documented in the existing literature, including multiple studies and case reports [ 40 – 49 ] and is diagnosed clinically by excluding other causes of thrombocytopenia and documenting resolution of thrombocytopenia upon drug discontinuation. This adverse effect resulting from tirofiban and other GP IIB/IIIa inhibitors is particularly concerning, considering how widely they are used in modern cardiovascular medicine practice for treatment of NSTEMIs and during percutaneous coronary interventions.…”

Section: Discussionmentioning

confidence: 99%

A Case of Hyperacute Severe Thrombocytopenia Occurring Less than 24 Hours after Intravenous Tirofiban Infusion

Meghrajani

Sabharwal

Namana

et al. 2018

Case Reports in Hematology

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Thrombocytopenia is defined as a condition where the platelet count is below the lower limit of normal (<150 G/L), and it is categorized as mild (100–149 G/L), moderate (50–99 G/L), and severe (<50 G/L). We present here a 79-year-old man who developed severe thrombocytopenia with a platelet count of 6 G/L, less than 24 hours after intravenous tirofiban infusion that was given to the patient during a percutaneous transluminal coronary angioplasty procedure with placement of 3 drug-eluting stents. The patient's baseline platelet count was 233 G/L before the procedure. Based on the timeline of events during hospitalization and laboratory evidence, it was highly likely that the patient's thrombocytopenia was the result of tirofiban-induced immune thrombocytopenia, a type of drug-induced immune thrombocytopenia (DITP) which occurs due to drug-dependent antibody-mediated platelet destruction. Anticoagulant-mediated artefactual pseudothrombocytopenia was ruled out as no platelet clumping was seen on the peripheral blood smears. The treatment of DITP includes discontinuation of the causative drug; monitoring of platelet count recovery; or treatment of severe thrombocytopenia with glucocorticoids, IVIG, or platelet transfusions depending on the clinical presentation. The most likely causative agent of this patient's thrombocytopenia—tirofiban—was discontinued, and the patient did not develop any signs of bleeding during the remainder of his hospital stay. His platelet count gradually improved to 24 G/L, and he was discharged on the sixth hospital day.

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“…DITP typically occurs 1-2 weeks after beginning a new drug or suddenly after a single dose of a drug which has previously been taken [134,135]. Exceptions include first doses of antithrombotic agents such as tirofiban [136][137][138][139]. Table 11 contains a list of ICU drugs associated with thrombocytopenia.…”

Section: Drug-induced Thrombocytopeniamentioning

confidence: 99%