Thrombocytopenia in acute coronary syndromes: etiologies and proposed management

Can J Cardiol. 2015 Jun;31(6):809-11. doi: 10.1016/j.cjca.2014.12.034. Epub 2015 Jan 10.

Abstract

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / therapy
  • Angioplasty, Balloon, Coronary / methods*
  • Aspirin / therapeutic use
  • Clopidogrel
  • Drug Therapy, Combination
  • Electrocardiography / methods
  • Enzyme-Linked Immunosorbent Assay
  • Eptifibatide
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / therapy*
  • Peptides / adverse effects*
  • Peptides / therapeutic use
  • Platelet Aggregation Inhibitors / adverse effects*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Platelet Count
  • Platelet Transfusion
  • Risk Assessment
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / physiopathology
  • Thrombocytopenia / therapy*
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Treatment Outcome

Substances

  • Peptides
  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Eptifibatide
  • Ticlopidine
  • Aspirin