Eptifibatide-Induced Severe Thrombocytopenia After ST-Elevation Myocardial Infarction (STEMI): A Case Report

Gheith, Zaid; Kilani, Areej; Nguyên, Tam

doi:10.7759/cureus.29549

Cited by 3 publications

(23 citation statements)

References 11 publications

(14 reference statements)

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“…15 Most of the manifestations of this kind of thrombocytopenia are negligible, such as petechia or minor bleeding from intravenous access. However, more serious cases, such as gastrointestinal bleeding, hematuria, and life-threatening bleeding that need immediate management can be seen 16 The management of eptifibatide thrombocytopenia depends on the severity of the condition and the platelet count. Similar to other suspected drug-induced thrombocytopenia other causes should be investigated and ruled out by a complete history taking, physical examination, and laboratory data evaluation.…”

Section: T a B L Ementioning

confidence: 99%

“…Eptifibatide-induced severe thrombocytopenia after STelevation myocardial infarction (STEMI): A case report Zaid Gheith, et al 16 69-year-old male ST-elevation myocardial infarction Gross hematuria and a petechial rash, platelet count of 3000cells/mm Although using IVIG as a treatment for this condition is not an option, corticosteroids might be used in refractory cases with severe and hard-to-stop bleeding. 18,19 In Table 2, similar cases of eptifibatide-induced thrombocytopenia are mentioned.…”

Section: Treatment and The Final Consequencementioning

confidence: 99%

See 1 more Smart Citation

A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

Safi,

Nazari,

Senobari

et al. 2024

Clinical Case Reports

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Eptifibatide, a GPIIb/IIIa receptor inhibitor, has shown its efficacy and safety in patients with high clot burden in their coronary vessels. It is widely used in patients with this condition. However, this medication use is accompanied by complications in some cases. Thrombocytopenia which is a relatively common condition in patients admitted to the hospital, especially in the acute setting, can be caused by medications. This condition can occur as an antibody or non‐antibody‐mediated process, caused by medications, such as heparin, clopidogrel, and eptifibatide. In this case, we present a woman with acute coronary syndrome and a complex lesion with a clot in her coronary vessel who was treated with eptifibatide. It led to asymptomatic thrombocytopenia. Once detected in laboratory data, the infusion was held, and the platelet count recovered in less than 5 days without additional treatment for this adverse effect. Eptifibatide is a medication used to treat acute coronary syndrome patients with a large thrombus in their coronary vessels. The mechanism of inducing thrombocytopenia by eptifibatide has not been proven yet, but it might be related to IgG antibodies. The severity of the disease can vary significantly, and the treatment is based on this factor. However, the main pillar of the treatment is the cessation of eptifibatide as soon as possible. This case draws the attention of physicians to one of the infrequent adverse effects of a commonly used medication in cardiology patients. Thrombocytopenia and its manifestations should be investigated and considered in patients who receive eptifibatide.

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Section: T a B L Ementioning

confidence: 99%

Section: Treatment and The Final Consequencementioning

confidence: 99%

A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

Safi,

Nazari,

Senobari

et al. 2024

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

“…However, patients must be exposed to eptifibatide for 5–7 days before they develop sensitization when receiving it for the first time. EIT was reported in several case studies and occurred in approximately 1 to 2% of patients [ 109 , 110 , 111 , 112 , 113 , 114 ].…”

Section: Eptifibatidementioning

confidence: 99%

Eptifibatide, an Older Therapeutic Peptide with New Indications: From Clinical Pharmacology to Everyday Clinical Practice

Tonin

Klen

2023

IJMS

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Therapeutic peptides are oligomers or short polymers of amino acids used for various medical purposes. Peptide-based treatments have evolved considerably due to new technologies, stimulating new research interests. They have been shown to be beneficial in a variety of therapeutic applications, notably in the treatment of cardiovascular disorders such as acute coronary syndrome (ACS). ACS is characterized by coronary artery wall damage and consequent formation of an intraluminal thrombus obstructing one or more coronary arteries, leading to unstable angina, non-ST elevated myocardial infarction, and ST-elevated myocardial infarction. One of the promising peptide drugs in the treatment of these pathologies is eptifibatide, a synthetic heptapeptide derived from rattlesnake venom. Eptifibatide is a glycoprotein IIb/IIIa inhibitor that blocks different pathways in platelet activation and aggregation. In this narrative review, we summarized the current evidence on the mechanism of action, clinical pharmacology, and applications of eptifibatide in cardiology. Additionally, we illustrated its possible broader usage with new indications, including ischemic stroke, carotid stenting, intracranial aneurysm stenting, and septic shock. Further research is, however, required to fully evaluate the role of eptifibatide in these pathologies, independently and in comparison to other medications.

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“…Comorbidities considered in these patients were widely Diabetes Mellitus [ 32 , 40 , 42 ], hypertension [ 31 , 32 , 37 - 40 , 42 ], CAD [ 31 , 32 , 36 , 37 , 40 ], Prosthetic valve replacement [ 41 ], Liver cirrhosis [ 35 ]. Risk factors include smoking [ 31 , 36 , 38 - 40 ], alcohol use [ 31 , 35 ], and recreational drug use such as cocaine [ 31 ].…”

Section: Reviewmentioning

confidence: 99%

“…Abciximab was predominantly used in four cases aged 53-75 [ 33 , 38 , 39 , 41 ]. Eptifibatide [ 31 , 32 , 34 , 35 , 40 , 43 ] was used in six patients within the age range of 34-75 years. Tirofiban was used to treat three patients, 68-84 years of age [ 36 , 37 , 42 ].…”

Section: Reviewmentioning

confidence: 99%

Adverse Drug Effect Profiles of Gp2b/3a Inhibitors: A Comparative Review of the Last Two Decades

Hasan,

Jauregui,

Zubair

et al. 2023

Cureus

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ST-Elevation Myocardial Infarction and non-ST Elevation Myocardial Infarction belong to the acute coronary syndrome group of diseases. These conditions are characterized by the complete or partial blockage of one or several coronary arteries, resulting in myocardial injury or necrosis. Various medications are used in their treatment, with the most recent addition being Glycoprotein IIb/IIIa inhibitors. They work by hindering the activity of glycoprotein IIb/IIIa receptors, which, in turn, prevents the clumping of platelets. Some of the GpIIb/IIIa inhibitors available in this category include abciximab, tirofiban, eptifibatide, roxifiban, and orbofiban. With this comprehensive literature review, we aimed to explore the potential adverse effects of these medications and compare the three in terms of their side effects profile. We searched through PubMed and Google Scholar and pinpointed 13 articles aligned with our inclusion criteria: six articles utilized eptifibatide, four were related to abciximab, and three used tirofiban. In 85% of the cases, a severe drop in platelet count, reaching as low as 1000/μL, was reported. Additionally, several other side effects were noted: one case documented multiple bruising spots appearing around the patient's body, two cases reported diffuse alveolar hemorrhage, and one case described a cardiac tamponade resulting from hemorrhagic pericarditis. Our study highlights the crucial significance of keeping a watchful eye on and comprehending the potential drawbacks linked to these medications in cardiovascular treatment. The necessity of researching these medications and their side effects is also evident, as this will significantly enhance the quality of treatment provided.

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Eptifibatide-Induced Severe Thrombocytopenia After ST-Elevation Myocardial Infarction (STEMI): A Case Report

Cited by 3 publications

References 11 publications

A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

Eptifibatide, an Older Therapeutic Peptide with New Indications: From Clinical Pharmacology to Everyday Clinical Practice

Adverse Drug Effect Profiles of Gp2b/3a Inhibitors: A Comparative Review of the Last Two Decades

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