NoBlood

Canadian Journal of Cardiology

June 2003, Volume 19, Number 7: 797-801



Acute thrombocytopenia associated with eptifibatide therapy

Y Khaykin, FL Paradiso-Hardy, M Madan

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.

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

PATIENTS AND 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´109/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.

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Mr. Jan B. Wade
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