Acute profound thrombocytopenia after treatment with tirofiban and off-pump coronary artery bypass grafting.
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.
Beiras-Fernandez
Andres
A
Department of Cardiac Surgery, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany. andres.beiras@med.uni-muenchen.de
Kowert
Anke
A
Jiru
Pascale
P
Weis
Marion
M
Spannagl
Michael
M
Reichart
Bruno
B
Schmoeckel
Michael
M
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
D010975:Platelet Aggregation Inhibitors; D014443:Tyrosine; D006493:Heparin; D000077466:Tirofiban