Safi Morteza, Nazari Roozbeh, Senobari Nahid, Taheri Homa, Ebrahimi Pouya
Cardiovascular Research Center Shahid Beheshti University of Medical Sciences, Modarres Hospital Tehran Iran.
Cedars-Sinai Cardiology Department California USA.
Clin Case Rep. 2024 Mar 28;12(4):e8694. doi: 10.1002/ccr3.8694. eCollection 2024 Apr.
Eptifibatide, a GPIIb/IIIa receptor inhibitor, has shown its efficacy and safety in patients with high clot burden in their coronary vessels. It is widely used in patients with this condition. However, this medication use is accompanied by complications in some cases. Thrombocytopenia which is a relatively common condition in patients admitted to the hospital, especially in the acute setting, can be caused by medications. This condition can occur as an antibody or non-antibody-mediated process, caused by medications, such as heparin, clopidogrel, and eptifibatide. In this case, we present a woman with acute coronary syndrome and a complex lesion with a clot in her coronary vessel who was treated with eptifibatide. It led to asymptomatic thrombocytopenia. Once detected in laboratory data, the infusion was held, and the platelet count recovered in less than 5 days without additional treatment for this adverse effect. Eptifibatide is a medication used to treat acute coronary syndrome patients with a large thrombus in their coronary vessels. The mechanism of inducing thrombocytopenia by eptifibatide has not been proven yet, but it might be related to IgG antibodies. The severity of the disease can vary significantly, and the treatment is based on this factor. However, the main pillar of the treatment is the cessation of eptifibatide as soon as possible. This case draws the attention of physicians to one of the infrequent adverse effects of a commonly used medication in cardiology patients. Thrombocytopenia and its manifestations should be investigated and considered in patients who receive eptifibatide.
依替巴肽是一种糖蛋白IIb/IIIa受体抑制剂，已在冠状动脉内血栓负荷高的患者中显示出疗效和安全性。它广泛用于患有这种病症的患者。然而，在某些情况下，这种药物的使用会伴随着并发症。血小板减少症在住院患者中是一种相对常见的病症，尤其是在急性情况下，可能由药物引起。这种情况可作为抗体或非抗体介导的过程发生，由肝素、氯吡格雷和依替巴肽等药物引起。在本病例中，我们介绍了一名患有急性冠状动脉综合征且冠状动脉有复杂病变并伴有血栓的女性，她接受了依替巴肽治疗。这导致了无症状性血小板减少症。一旦在实验室数据中检测到，就停止输注，血小板计数在不到5天的时间内恢复，且未针对这种不良反应进行额外治疗。依替巴肽是一种用于治疗冠状动脉内有大血栓的急性冠状动脉综合征患者的药物。依替巴肽诱导血小板减少症的机制尚未得到证实，但可能与IgG抗体有关。疾病的严重程度可能有很大差异，治疗也基于这一因素。然而，治疗的主要支柱是尽快停用依替巴肽。本病例引起了医生对心脏病患者常用药物罕见不良反应之一的关注。在接受依替巴肽治疗的患者中，应调查并考虑血小板减少症及其表现。
