Continuous intravenous infusion of dipyridamole as adjunctive therapy in the treatment of thrombotic thrombocytopenic purpura

Quintini, Gerlando; Barbera, Vincenzo; Iannitto, Emilio; Spadola, Vincenzo; Fadda, Raffaela; Greco, Gabriele H.; Mazzola, Giuseppina; Mariani, Guglielmo

doi:10.1016/s1473-0502(03)00118-6

Cited by 4 publications

(4 citation statements)

References 13 publications

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“…Venous thromboembolism (VTE) rates in iTTP vary from 3.8% to 13% [2,[11][12][13][14] (Table 1). In a study consisting of 77 patients, one (6%) VTE episode was catheter-related [15]. Rizvi et al [12] report a VTE incidence of 12.6%, majority of which were catheter-related thrombosis.…”

Section: Thrombotic and Bleeding Events In Ttp In The Pre-caplacizumab Eramentioning

confidence: 98%

“…There was limited data on bleeding presented in the previous TTP studies, and minor bleeding episode rates were reported to be between 8% -80% (Table 1). These rates were higher especially if antiplatelets were used [15,16]. In the study of Quintini et al [15], 80% of patients receiving standard therapy plus dipyridamole infusion had bleeding episodes, none of which were severe.…”

Section: Thrombotic and Bleeding Events In Ttp In The Pre-caplacizumab Eramentioning

confidence: 99%

“…These rates were higher especially if antiplatelets were used [15,16]. In the study of Quintini et al [15], 80% of patients receiving standard therapy plus dipyridamole infusion had bleeding episodes, none of which were severe. In a randomized study, in which patients received either dual antiplatelet therapy (aspirin+dipyridamole) or placebo, treatment efficacy between two arms were comparable with minor and transient bleeding episodes in patients with antiplatelets [16] (Table 1).…”

Section: Thrombotic and Bleeding Events In Ttp In The Pre-caplacizumab Eramentioning

confidence: 99%

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Do patients with immune-mediated thrombotic thrombocytopenic purpura receiving caplacizumab need antithrombotic therapy?

Elverdi

Çerme

Aydın

et al. 2021

Expert Review of Clinical Pharmacology

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Section: Thrombotic and Bleeding Events In Ttp In The Pre-caplacizumab Eramentioning

confidence: 98%

Section: Thrombotic and Bleeding Events In Ttp In The Pre-caplacizumab Eramentioning

confidence: 99%

Section: Thrombotic and Bleeding Events In Ttp In The Pre-caplacizumab Eramentioning

confidence: 99%

See 1 more Smart Citation

Do patients with immune-mediated thrombotic thrombocytopenic purpura receiving caplacizumab need antithrombotic therapy?

Elverdi

Çerme

Aydın

et al. 2021

Expert Review of Clinical Pharmacology

View full text Add to dashboard Cite

“…In addition, ticlopidine maintenance was shown to prevent relapses after 1 year[30]. Some authors even suggest intravenous infusion of dipyridamole as an adjunctive therapy[31]. However, the mechanisms of thrombi formation in TTP may differ from atherothrombotic ACS.…”

Section: Treatment For Cardiac Complications In Ttpmentioning

confidence: 99%

Cardiac implications of thrombotic thrombocytopenic purpura

Wiernek¹,

Jiang²,

Gustafson³

et al. 2018

WJC

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Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder that essentially can affect any organ in the human body. The hallmark of the pathogenesis in TTP is the large von Willebrand factor multimers on platelet-mediated micro-thrombi formation, leading to microvascular thrombosis. Autopsy studies showed that cardiac arrest and myocardial infarction are the most common immediate causes of death in these patients. Clinical manifestations of cardiac involvement in TTP vary dramatically, from asymptomatic elevation of cardiac biomarkers, to heart failure, MI and sudden cardiac death. There is limited knowledge about optimal cardiac evaluation and management in patients with TTP. The absence of typical cardiac symptoms, combined with complicated multi-organ involvement in TTP, may contribute to the under-utilization of cardiac evaluation and treatment. Prompt diagnosis and timely initiation of effective therapy could be critically important in selected cases. Based on our experience and this review of the literature, we developed several recommendations for focused cardiac evaluation for patients with acute TTP: (1) patients with suspected or confirmed TTP should be screened for the potential presence of cardiac involvement with detailed history and physical, electrocardiogram and cardiac enzymes; (2) clinical deterioration of TTP patients warrants immediate cardiac reevaluation; (3) TTP patients with clinical evidence of cardiac involvement should be monitored for telemetry, cardiac biomarkers and evaluated with transthoracic echocardiography. These patients require urgent targeted TTP treatment as well as cardiac-specific treatment. Aspirin therapy is indicated for all TTP patients. Since epicardial coronary artery involvement is rare, cardiac catheterization is usually not required, given the high risk for hemorrhage and kidney injury; (4) we recommend evidence-based medical therapy for ischemic symptoms and heart failure. TTP patients with evidence of cardiac involvement would also benefit from routine cardiology follow up during remission.

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Hematologic Issues in Medical Consultation

Steinberg¹,

Ahmad²

2007

Evidence-Based Medical Consultation

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Continuous intravenous infusion of dipyridamole as adjunctive therapy in the treatment of thrombotic thrombocytopenic purpura

Cited by 4 publications

References 13 publications

Do patients with immune-mediated thrombotic thrombocytopenic purpura receiving caplacizumab need antithrombotic therapy?

Do patients with immune-mediated thrombotic thrombocytopenic purpura receiving caplacizumab need antithrombotic therapy?

Cardiac implications of thrombotic thrombocytopenic purpura

Hematologic Issues in Medical Consultation

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