title: Acute profound thrombocytopenia after treatment with tirofiban and off-pump coronary artery bypass grafting.
abstract: The glycoprotein IIb/IIIa (GP IIb/IIIa) receptor antagonists prevent platelet aggregation and thrombus formation, improving outcomes of patients with acute coronary syndrome. Therapy with these agents may lead to bleeding complications and thrombocytopenia, challenging the perioperative management of patients undergoing coronary surgery. We report the successful management of an acute profound thrombocytopenia after urgent off-pump coronary surgery in a patient treated with tirofiban for unstable angina and acute coronary syndrome.
authors.affiliation: Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany. andres.beiras@med.uni-muenchen.de
authors.forename: Andres
authors.initials: A
authors.lastname: Beiras-Fernandez
authors.forename: Anke
authors.initials: A
authors.lastname: Kowert
authors.forename: Pascale
authors.initials: P
authors.lastname: Jiru
authors.forename: Marion
authors.initials: M
authors.lastname: Weis
authors.forename: Michael
authors.initials: M
authors.lastname: Spannagl
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
authors.forename: Michael
authors.initials: M
authors.lastname: Schmoeckel
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D000208:Acute Disease; D000789:Angina, Unstable / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D010976:Platelet Count; D017713:Platelet Transfusion / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D013927:Thrombosis / Q000517:prevention & control*; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D014443:Tyrosine; D006493:Heparin; D000077466:Tirofiban