Thrombocytopenia in acute coronary syndromes: etiologies and proposed management.
Thrombocytopenia in acute coronary syndromes (ACS) can arise from a variety of etiologies. Glycoprotein IIb/IIIa receptor antagonists have improved clinical outcomes in ACS, however, profound thrombocytopenia can occur with use of these agents. We present a case of profound thrombocytopenia due to administration of a glycoprotein IIb/IIIa receptor antagonist, eptifibatide, after percutaneous coronary intervention for an inferior ST-elevation myocardial infarction. We review the major causes and suggest an approach for diagnosis and management of thrombocytopenia in ACS.
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
Abhinav
A
Sharma
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
Craig
C
Ferguson
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address: kevin.bainey@albertahealthservices.ca.
Kevin R
KR
Bainey
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay; D000077542:Eptifibatide; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D010455:Peptides / Q000009:adverse effects* / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D010976:Platelet Count; D017713:Platelet Transfusion; D018570:Risk Assessment; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D000077542:Eptifibatide; D013988:Ticlopidine; D001241:Aspirin