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Angiology
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Profound Thrombocytopenia Associated with Tirofiban

Case Report and Review of Literature

Saumil Patel, MD

Internal Medicine, Department of Medicine, New York Methodist Hospital, Brooklyn, NY

Manali Patel, MD

Internal Medicine, Department of Medicine, New York Methodist Hospital, Brooklyn, NY

Iftikhar Din, MD

Internal Medicine, Department of Medicine, New York Methodist Hospital, Brooklyn, NY

C. V. R. Reddy, MD, FACC

Division of Cardiology, Department of Medicine, New York Methodist Hospital, Brooklyn, NY

John Kassotis, MD, Eng Sci D, FACC

Division of Cardiology, Department of Medicine, Clinical Electrophysiology Services, Division of Cardiology, Department of Medicine, New York Methodist Hospital, Brooklyn, NY, JTK747{at}aol.com

Platelet glycoprotein (GP) IIb/IIIa inhibitors prevent fibrinogen binding and platelet aggregation. Inhibition of platelet activity at the injured coronary plaque is a target for novel therapeutic strategies. They decrease ischemic complications associated with non-ST-segment elevation acute coronary syndromes and percutaneous coronary intervention. Thrombocytopenia is a serious complication well described with the use of the prototype GP IIb/IIIa inhibitor abciximab. Its association with other agents of this class has been underemphasized. It is important to monitor platelet counts closely after initiation of GP IIb/IIIa inhibitor therapy, not only for abciximab, but also for small molecule inhibitors such as eptifibatide and tirofiban. Monitoring of platelet counts at 2 to 6 hours and 24 hours will detect most cases of acute thrombocytopenia. Adverse events may be prevented by prompt discontinuation of GP IIb/IIIa inhibitor therapy. The authors present a case of profound thrombocytopenia after the administration of tirofiban in the treatment of a patient with an acute coronary syndrome.

Angiology, Vol. 56, No. 3, 351-355 (2005)
DOI: 10.1177/000331970505600319
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