Tirofiban-associated acute thrombocytopenia

Abstract

Randomized clinical trials of glycoprotein IIb/IIIa inhibition during percutaneous coronary intervention have shown significant clinical efficacy and safety in reducing the morbidity and mortality. In Turkey, only tirofiban is available. Tirofiban is a safe and effective agent in combination with heparin and aspirin in the setting of an acute coronary syndrome. In previous studies involving tirofiban, the incidence of bleeding complications was more frequent than heparin alone but major bleeding complications were seen in 5.3% of patients receiving tirofiban and not significantly different from the heparin-only treated patients. The incidence of thrombocytopenia, defined as an absolute platelet count of < 90,000/mm(3), was 0.4% in the PRISM, 1.9% in PRISM-PLUS and 1.1% in RESTORE trials. We reported a case of acute profound thrombocytopenia 48 hours after the administration of tirofiban in the treatment of a patient with an acute coronary syndrome and tirofiban discontinuation was sufficient in the management of this condition.