Khaykin Yaariv, Paradiso-Hardy Fran L, Madan Mina
Division of Cardiology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Can J Cardiol. 2003 Jun;19(7):797-801.
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.
To determine the incidence of thrombocytopenia in a cohort of patients treated with eptifibatide at a tertiary cardiac centre.
Chart review of consecutive patients treated with eptifibatide at the study institution.
There were four (1.3%) cases of acute thrombocytopenia (platelet count less than 100 x 10(9)/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.
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.
