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.