Pulmonary Hemorrhage After Percutaneous Coronary Intervention With Abciximab Therapy

Choi, Rak Kyeong; Lee, Nae Hee; Lim, Dal Soo; Hong, Suk Keun; Hwang, Hweung Kon

doi:10.4065/77.12.1340

Cited by 13 publications

(8 citation statements)

References 17 publications

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“…Only two patients in the eptifibatide group received blood transfusions (2 and 4 units). The LVEDP was elevated in four of the five eptifibatide-treated patients (80%) (Mean: 27.4, range 11-37) and in three of the five abciximab-treated patients (60%) (Mean: 23, range [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Nine of the 11 patients were smokers or ex-smokers.…”

Section: Resultsmentioning

confidence: 99%

“…8,10,20 Cases of AH have been reported sporadically for all three GP IIb/IIIa inhibitors. [13][14][15][21][22][23][24] In a study by Ali et al, the incidence of pulmonary hemorrhage for abciximab, eptifibatide, and tirofiban were 0.7%, 0.5%, and 0.9%, respectively (P = NS). 20 A prolonged ACT as well as an elevated PTT was present in most patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Alveolar Hemorrhage: An Underdiagnosed Complication of Treatment with Glycoprotein IIb/IIIa Inhibitors

Iskandar

Kasasbeh

Mechleb³

et al. 2006

J Interven Cardiology

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Alveolar Hemorrhage: An Underdiagnosed Complication of Treatment with Glycoprotein IIb/IIIa Inhibitors

Iskandar

Kasasbeh

Mechleb³

et al. 2006

J Interven Cardiology

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“…In previously reported case series (3)(4)(5), mortality ranged from 29% to 50%. As illustrated in the present case, pulmonary hemorrhage may often initially be misdiagnosed as pulmonary edema or pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Abciximab-Induced Alveolar Hemorrhage after Percutaneous Coronary Intervention.

Conley¹,

Allan²,

Almaleh³

2006

Southern Medical Journal

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A bciximab, a platelet glycoprotein (GP) IIb/IIIa inhibitor, has been shown to improve clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). However, there is a well-documented increase in bleeding risk associated with use of this agent. Several types of bleeding, including groin site, intracranial, gastrointestinal, genitourinary and pulmonary, have been described. Spontaneous pulmonary hemorrhage is a particularly rare and easily misdiagnosed complication that requires early diagnosis to ensure patient survival. CASE PRESENTATIONA 61-year-old man with no previous history of coronary artery disease presented to the emergency department for evaluation of chest pain associated with diaphoresis. His initial electrocardiogram Abciximab, a platelet glycoprotein (GP) IIb/IIIa inhibitor, has been shown to improve clinical outcomes in patients undergoing percutaneous coronary intervention. However, there is a well-documented increase in bleeding risk associated with the use of this agent. Spontaneous pulmonary hemorrhage is a particularly rare and easily misdiagnosed complication that requires early diagnosis to ensure patient survival. A 61-year-old man presented to the emergency department with chest pain and inferolateral ST elevation on electrocardiogram. A paclitaxel drugeluting stent was then placed in the left circumflex artery, without complications. Abciximab (a bolus of 0.25 mg/kg followed by an infusion of 10 mg/min for 12 h) was given. Approximately 20 min later, the patient developed dyspnea and hemoptysis. A chest radiograph revealed new bilateral diffuse interstitial infiltrates, and the patient was started on empirical antibiotics for pneumonia. Because of increasing dyspnea and somnolence, the patient was intubated and bronchoscopy was performed, revealing serial hemorrhagic returns from the left lower lobe, diagnostic of diffuse alveolar hemorrhage and judged to be secondary to abciximab, given the time course. All antiplatelet and antithrombotic agents were stopped. The patient stabilized over the next several days, with some recurrent hemoptysis, and was successfully extubated seven days later. Prognosis remains poor in GP IIb/IIIa inhibitor-induced pulmonary hemorrhage, and early diagnosis is critical so that antithrombotic and antiplatelet agents may be discontinued in a timely manner. A high degree of suspicion is required when treating a patient who presents with dyspnea and new radiological infiltrates after receiving a GP IIb/IIIa inhibitor.

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“…Routine administration of these agents, however, incurs substantial financial expense and an increased risk of procedure-related hemorrhage that in certain instances can be serious or fatal (17).…”

Section: See Page 1900mentioning

confidence: 99%

A twist in our understanding of enzyme elevation after coronary intervention**Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.

Williams

2003

Journal of the American College of Cardiology

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Pulmonary Hemorrhage After Percutaneous Coronary Intervention With Abciximab Therapy

Cited by 13 publications

References 17 publications

Alveolar Hemorrhage: An Underdiagnosed Complication of Treatment with Glycoprotein IIb/IIIa Inhibitors

Alveolar Hemorrhage: An Underdiagnosed Complication of Treatment with Glycoprotein IIb/IIIa Inhibitors

Abciximab-Induced Alveolar Hemorrhage after Percutaneous Coronary Intervention.

A twist in our understanding of enzyme elevation after coronary intervention**Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.

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