Profound thrombocytopenia associated with tirofiban: case report and review of literature.
Platelet glycoprotein (GP)IIb/IIIa inhibitors prevent fibrinogen binding and platelet aggregation. Inhibition of platelet activity at the injured coronary plaque is a target for novel therapeutic strategies. They decrease ischemic complications associated with non-ST-segment elevation acute coronary syndromes and percutaneous coronary intervention. Thrombocytopenia is a serious complication well described with the use of the prototype GP IIb/IIIa inhibitor abciximab. Its association with other agents of this class has been underemphasized. It is important to monitor platelet counts closely after initiation of GP IIb/IIIa inhibitor therapy, not only for abciximab, but also for small molecule inhibitors such as eptifibatide and tirofiban. Monitoring of platelet counts at 2 to 6 hours and 24 hours will detect most cases of acute thrombocytopenia. Adverse events may be prevented by prompt discontinuation of GP IIb/IIIa inhibitor therapy. The authors present a case of profound thrombocytopenia after the administration of tirofiban in the treatment of a patient with an acute coronary syndrome.
Patel
Saumil
S
Internal Medicine, Department of Medicine, New York Methodist Hospital, Brooklyn, 11215, USA.
Patel
Manali
M
Din
Iftikhar
I
Reddy
C V R
CV
Kassotis
John
J
D000368:Aged; D003327:Coronary Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013577:Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced*; D000077466:Tirofiban; D014443:Tyrosine / Q000009:adverse effects* / Q000031:analogs & derivatives*
D010975:Platelet Aggregation Inhibitors; D014443:Tyrosine; D000077466:Tirofiban