Severe acute thrombocytopenia associated with the use of intravenous tirofiban, after percutaneous coronary intervention
Keywords:
angioplasty, critical care, coronary heart disease, tirofiban, thrombocytopeniaAbstract
Introduction: Glycoprotein IIb/IIIa inhibitors are potent drugs in inhibiting platelet aggregation and are used in settings of acute or chronic coronary syndrome led topercutaneouscoronaryinterventionorwithevidenceofthromboticcomplicationor non-reflux phenomenon. However, these drugs are associated with thrombocytopenia and with the use of tirofiban it occurs in 0.4 to 5.6% of cases.
Objective: To present a case of severe acute thrombocytopenia after the infusion of tirofiban and to discuss the pathophysiology, approach and treatment of this disease.
Clinical case: 61-year-old male patient, with a pathological history of controlled hypertension, with a clinical picture of typical recurrent angina pain with myocardial perfusion study with positive exercise stress for induction of anterior wall ischemia. A coronary arteriography was performed, which reported multivessel disease, angioplasty and a medicated stent implantation were performed, and bolus tirofiban and subsequent infusion were indicated. He developed acute severe thrombocytopenia at 24 hours, a platelet unit was indicated by apheresis with good transfusion performance, and it was decided to suspend tirofiban, with resolution of the thrombocytopenia and there was no bleeding complication.
Conclusion: Acute severe thrombocytopenia induced by glycoprotein IIb/ IIIa inhibitors is a rare adverse effect, which can be detected in a timely manner by monitoring the platelet count. To ensure the safe use of these drugs in acute coronary syndrome or percutaneous coronary intervention scenarios.
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References
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