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Acute Profound Thrombocytopenia after Using Abciximab for No-Reflow during Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

  • Park, Soonyoung (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Lee, Jooyoung (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Lee, Sang Yeub (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Bae, Jang-Whan (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Hwang, Kyung-Kuk (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Kim, Dong-Woon (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Cho, Myeong-Chan (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Kim, Sang Min (Regional Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Chungbuk National University Hospital)
  • Published : 2013.08.30

Abstract

Glycoprotein IIb/IIIa antagonists are well established for their effectiveness in improving clinical outcomes in acute coronary syndrome patients undergoing percutaneous coronary intervention. Acute profound thrombocytopenia is a rare complication of abciximab. We present a case which was managed successfully for the rare complication of acute profound thrombocytopenia after using abciximab and an intra-aortic balloon pump for the treatment of a no-reflow phenomenon and consecutive cardiogenic shock during primary percutaneous coronary intervention.

Keywords

References

  1. Makoni SN. Acute profound thrombocytopenia following angioplasty: the dilemma in the management and a review of the literature. Heart 2001;86:E18. https://doi.org/10.1136/heart.86.6.e18
  2. Coller BS. Blockade of platelet GPIIb/IIIa receptors as an antithrombotic strategy. Circulation 1995;92:2373-80. https://doi.org/10.1161/01.CIR.92.9.2373
  3. Use of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angioplasty. The EPIC Investigation. N Engl J Med 1994;330:956-61. https://doi.org/10.1056/NEJM199404073301402
  4. Lincoff AM, Mark DB, Tcheng JE, et al. Economic assessment of platelet glycoprotein IIb/IIIa receptor blockade with abciximab and low-dose heparin during percutaneous coronary revascularization: results from the EPILOG randomized trial. Evaluation in PTCA to Improve Long-term Outcome with abciximab GP IIb/IIIa blockade. Circulation 2000;102:2923-9. https://doi.org/10.1161/01.CIR.102.24.2923
  5. EPISTENT Investigators. Randomised placebo-controlled and balloonangioplasty-controlled trial to assess safety of coronary stenting with use of platelet glycoprotein-IIb/IIIa blockade. Lancet 1998;352:87-92. https://doi.org/10.1016/S0140-6736(98)85010-1
  6. Merlini PA, Rossi M, Menozzi A, et al. Thrombocytopenia caused by abciximab or tirofiban and its association with clinical outcome in patients undergoing coronary stenting. Circulation 2004;109:2203-6. https://doi.org/10.1161/01.CIR.0000127867.41621.85
  7. Warkentin TE. Heparin-induced thrombocytopenia: pathogenesis and management. Br J Haematol 2003;121:535-55. https://doi.org/10.1046/j.1365-2141.2003.04334.x
  8. Claeys LG, Berg W. Major bleeding and severe thrombocytopenia after combined heparin and abciximab-c7E3 Fab therapy. Eur J Vasc Endovasc Surg 2003;25:85-7. https://doi.org/10.1053/ejvs.2002.1757
  9. Klein LW, Kern MJ, Berger P, et al. Society of cardiac angiography and interventions: suggested management of the no-reflow phenomenon in the cardiac catheterization laboratory. Catheter Cardiovasc Interv 2003;60:194-201. https://doi.org/10.1002/ccd.10620
  10. Butler MJ, Chan W, Taylor AJ, Dart AM, Duffy SJ. Management of the no-reflow phenomenon. Pharmacol Ther 2011;132:72-85. https://doi.org/10.1016/j.pharmthera.2011.05.010
  11. Abbo KM, Dooris M, Glazier S, et al. Features and outcome of no-reflow after percutaneous coronary intervention. Am J Cardiol 1995;75:778-82. https://doi.org/10.1016/S0002-9149(99)80410-X

Cited by

  1. Abciximab : Acute profound thrombocytopenia in an elderly patient: case report vol.1482, pp.1, 2013, https://doi.org/10.1007/s40278-013-7693-3