Why the study?
Although initial clinical trials did not identify a significant incidence of thrombocytopenia following eptifibatide treatment, this complication has become increasingly recognized in clinical practice.
Highlights a severe complication of eptifibatide-induced thrombocytopenia and thrombosis mediated by dependent anti-platelet antibodies.
Alerts clinicians to monitor platelets with eptifibatide in high-risk PCI; case extends post-marketing recognition of thrombocytopenia.
Introduction Eptifibitide and other glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors are commonly used with dual antiplatelet therapy for high-risk percutaneous coronary interventions (PCI) in the treatment of acute coronary syndromes. Although initial clinical trials did not identify a significant incidence of thrombocytopenia following eptifibatide treatment,[ 1 ] this complication has become more recognized over time in clinical practice. We report the case of a 60-year-old man with an ST-elevation myocardial infarction (STEMI), who developed profound thrombocytopenia as well as multiple venous and arterial thromboses after exposure to eptifibatide during high-risk PCI. We demonstrate the presence and activity of eptifibatide-dependent anti-platelet antibodies in this patient and present clinical data that supports a causal link between eptifibatide and this patient’s hematologic sequelae. * Authors contributed equally.
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Puram et al. (2020) studied this question.
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