Eptifibatide Induced Thrombocytopenia in Acute Coronary Syndrome: A Real-World Data

Background: Eptifibatide is a known antiplatelet that is used in patients undergoing percutaneous coronary intervention for ACS, and it is proven to have a positive outcome. Despite thrombocytopenia not being reported in the pivotal trials, the emerging literature associated this link. We aim to further investigate this association and provide real-world data from a single centre. Methods: A retrospective study was conducted in Heart Hospital at Hamad Medical Corporation from 2016 to 2022. All patients admitted with ACS and received Eptifibatide were included in the study. Patients with confirmed secondary causes of thrombocytopenia were excluded. The data is reported in the form of mean, median, standard deviation, interquartile range, and percentage. Results: Twenty-six patients met the inclusion criteria, with an average age of 54 ± 11 years, and all patients were males. The baseline platelets count was 157 ± 80, and haemoglobin was 14 ± 2. Fourteen patients had platelets drop by more than 50% of their baseline. Thrombocytopenia developed after eptifibatide infusion by 36 ± 29. The average haemoglobin post-eptifibatide infusion was 13.5 ± 1.7 g/dL. Three patients required platelet transfusion, 23 patients were managed conservatively, and one patient died. Conclusion: Eptifibatide can cause life-threatening thrombocytopenia, which can be simply reversed by ceasing the infusion. However, platelet transfusion might be necessary in some patients. Neither the mechanism nor the risk factors are clear, and further studies are recommended to understand this association better.