Glycoprotein IIb/IIIa Inhibitor-Associated Thrombocytopenia: Clinical Predictors and Effect on Outcome

Abstract

Glycoprotein IIb/IIIa inhibitors are used as an adjunct to antiplatelet therapy in percutaneous coronary intervention to reduce postprocedural enzyme elevations. Previous studies have shown a risk for thrombocytopenia that is associated with these agents. We sought to evaluate the incidence and outcomes of glycoprotein IIb/IIIa inhibitor-associated thrombocytopenia in an unselected series of patients undergoing percutaneous coronary intervention. We reviewed 984 interventions performed on 908 subjects over a specific time period. Glycoprotein IIb/IIIa inhibitors were used in 58.8% of cases. Their use increased from 38 to 82% during the study period (p < 0.0001). The incidence of glycoprotein IIb/IIIa inhibitor-associated thrombocytopenia was 5.4%. The occurrence of thrombocytopenia was not associated with higher age, gender or ethnicity. The preprocedural platelet count was not associated with induced thrombocytopenia (237 ± 76 vs. 209 ± 68 × 10³, p > 0.05). The occurrence of thrombocytopenia was not associated with increased in-hospital mortality, 1-year mortality, myocardial infarction or revascularization, but was associated with a hospital stay twice as long as in those patients without thrombocytopenia (5.6 ± 11.3 vs. 2.1 ± 2.2 days, p < 0.001). Of the 5.4% of patients who developed thrombocytopenia, only 2 patients (7.1%) required platelet or blood cell transfusion.

Eptifibatide induced acute thrombocytopenia. Case report of 80- years old man with acute coronary syndrome

“…Additionally, eGFR allowed a reduced dose of eptifibatide administration. Gp IIb/IIIa induced thrombo-cytopenia appears in 1-5.4% cases [2][3][4][5].…”

The Role of Glycoprotein IIb/IIIa Inhibitors- A Promise Not Kept?

“…All-cause mortality was markedly increased at 30 days (8.0% versus 1.6%, p = 0.0008) and at 1 year (10.0% versus 3.9%, p = 0.03). Thrombocytopenia [39] tends to at-least double the hospital stay.…”