Eptifibatide-induced thrombocytopenia: with thrombosis and disseminated intravascular coagulation immediately after left main coronary artery percutaneous coronary angioplasty

Tex Heart Inst J. 2012;39(1):86-91.

Abstract

Early clinical trials of eptifibatide did not show a significant association between eptifibatide and the development of thrombocytopenia, thrombosis, or disseminated intravascular coagulation. However, more recent literature has suggested a significant association between eptifibatide and the development of thrombocytopenia and thrombosis. Although the true incidence and the pathophysiology of these associations are unknown, the development of these events can be life-threatening. Herein, we describe the case of a patient who experienced acute onset of profound thrombocytopenia, developing thrombosis, pulmonary emboli, and disseminated intravascular coagulation. This paper adds to the few previous reports of cases that suggested an association between thrombocytopenia, thrombosis, and the administration of eptifibatide. To the best of our knowledge, this is the first case report in the medical literature that associates the new onset of thrombocytopenia, thrombosis, and disseminated intravascular coagulation with the administration of eptifibatide. We also provide a subject review.

Keywords: Disseminated intravascular coagulation/diagnosis/etiology/therapy; eptifibatide; percutaneous coronary angioplasty; platelet aggregation inhibitors/adverse effects; platelet glycoprotein GPIIb-IIIa complex/antagonists & inhibitors; thrombocytopenia/chemically induced/prevention & control/therapy; thrombosis/chemically induced.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary* / adverse effects
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Anticoagulants / therapeutic use
  • Blood Coagulation Tests
  • Coronary Artery Bypass / adverse effects*
  • Disseminated Intravascular Coagulation / blood
  • Disseminated Intravascular Coagulation / chemically induced*
  • Disseminated Intravascular Coagulation / diagnosis
  • Disseminated Intravascular Coagulation / therapy
  • Drug Substitution
  • Drug-Eluting Stents
  • Eptifibatide
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Peptides / adverse effects*
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Count
  • Predictive Value of Tests
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / chemically induced
  • Severity of Illness Index
  • Thrombocytopenia / blood
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / therapy
  • Thrombosis / blood
  • Thrombosis / chemically induced*
  • Thrombosis / diagnosis
  • Thrombosis / therapy
  • Time Factors
  • Treatment Outcome
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Peptides
  • Platelet Aggregation Inhibitors
  • Warfarin
  • Eptifibatide