Acute thrombocytopenia associated with eptifibatide therapy.
BACKGROUND
Platelet glycoprotein (GP) IIb/IIIa receptor blockade improves clinical outcomes in percutaneous coronary interventions and in acute coronary syndromes. Thrombocytopenia is a serious complication well described with the use of the prototype GPIIb/IIIa inhibitor abciximab. Its association with other agents of this class has been underemphasized.


OBJECTIVE
To determine the incidence of thrombocytopenia in a cohort of patients treated with eptifibatide at a tertiary cardiac centre.


METHODS
Chart review of consecutive patients treated with eptifibatide at the study institution.


RESULTS
There were four (1.3%) cases of acute thrombocytopenia (platelet count less than 100 x 10(9)/L) among 305 patients reviewed. One patient had been previously exposed to eptifibatide. The other three patients are described. In each case, platelet counts declined within 6 h of receiving eptifibatide. Recovery of platelet counts was noted within 6 to 30 h after withdrawal of eptifibatide. No patient suffered an adverse clinical event related to thrombocytopenia.


CONCLUSIONS
It is important to monitor platelet counts closely after initiation of GPIIb/IIIa inhibitor therapy, not only for abciximab, but also for small molecule inhibitors such as eptifibatide. Monitoring of platelet counts at 2 to 6 h and 24 h will detect most cases of acute thrombocytopenia. Adverse events may be prevented by prompt discontinuation of GPIIb/IIIa inhibitor therapy.
Khaykin
Yaariv
Y
Division of Cardiology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Paradiso-Hardy
Fran L
FL
Madan
Mina
M
D000368:Aged; D000789:Angina, Unstable / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D002170:Canada / Q000453:epidemiology; D000077542:Eptifibatide; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D010455:Peptides / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000453:epidemiology; D016896:Treatment Outcome
D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077542:Eptifibatide