Acute Profound Thrombocytopenia Induced by Eptifibatide Causing Diffuse Alveolar Hemorrhage

Byrd, Gregory; Custovic, Sabina; Byrd, David R.; Miano, Deanna Ingrassia; Bathla, Jasdeep; Attallah, Antonious

doi:10.1155/2021/8817067

Cited by 4 publications

(26 citation statements)

References 12 publications

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“…The mechanism of eptifibatide‐induced thrombocytopenia is not well known, but it has been attributed to both antibody‐mediated and non‐antibody‐mediated mechanisms 13,14 . There are studies stating the probable mechanism of eptifibatide‐induced thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

“…11 The platelet anti-aggregation effect of the bolus and drip infusion of eptifibatide can be observed as soon as 1 min and lasts for 4-6 h. 12 The mechanism of eptifibatide-induced thrombocytopenia is not well known, but it has been attributed to both antibody-mediated and non-antibody-mediated mechanisms. 13,14 There are studies stating the probable mechanism of eptifibatide-induced thrombocytopenia. Bougie.…”

Section: T a B L Ementioning

confidence: 99%

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A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

Safi,

Nazari,

Senobari

et al. 2024

Clinical Case Reports

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Eptifibatide, a GPIIb/IIIa receptor inhibitor, has shown its efficacy and safety in patients with high clot burden in their coronary vessels. It is widely used in patients with this condition. However, this medication use is accompanied by complications in some cases. Thrombocytopenia which is a relatively common condition in patients admitted to the hospital, especially in the acute setting, can be caused by medications. This condition can occur as an antibody or non‐antibody‐mediated process, caused by medications, such as heparin, clopidogrel, and eptifibatide. In this case, we present a woman with acute coronary syndrome and a complex lesion with a clot in her coronary vessel who was treated with eptifibatide. It led to asymptomatic thrombocytopenia. Once detected in laboratory data, the infusion was held, and the platelet count recovered in less than 5 days without additional treatment for this adverse effect. Eptifibatide is a medication used to treat acute coronary syndrome patients with a large thrombus in their coronary vessels. The mechanism of inducing thrombocytopenia by eptifibatide has not been proven yet, but it might be related to IgG antibodies. The severity of the disease can vary significantly, and the treatment is based on this factor. However, the main pillar of the treatment is the cessation of eptifibatide as soon as possible. This case draws the attention of physicians to one of the infrequent adverse effects of a commonly used medication in cardiology patients. Thrombocytopenia and its manifestations should be investigated and considered in patients who receive eptifibatide.

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Section: Discussionmentioning

confidence: 99%

Section: T a B L Ementioning

confidence: 99%

A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

Safi,

Nazari,

Senobari

et al. 2024

Clinical Case Reports

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show abstract

“…A significant but less reported side effect of eptifibatide is a profound drop in platelet count that occurs within hours after the infusion [1]. The mechanism of profound thrombocytopenia is poorly understood and is thought to be antibody-mediated, but antibody-independent pathways have also been proposed [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…Most patients develop minor bleeding, including petechiae or trivial bleeding from catheter sites. However, major bleeding, such as gastrointestinal bleeding or hematuria, has been reported, and some patients developed life-threatening bleeding necessitating further management [6,7].…”

Section: Discussionmentioning

confidence: 99%

Eptifibatide-Induced Severe Thrombocytopenia After ST-Elevation Myocardial Infarction (STEMI): A Case Report

Gheith¹,

Kilani²,

Nguyên³

2022

Cureus

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Eptifibatide is a platelet glycoprotein (GP) IIb/IIIa inhibitor that is used in certain cases of acute coronary syndrome, including those with high thrombus burden or with no-reflow. It can rarely be associated with severe thrombocytopenia, which brings up a dilemma in managing those patients who require antiplatelet therapy. We discuss a patient who had ST-elevation myocardial infarction (STEMI) and developed severe thrombocytopenia after eptifibatide infusion. He was managed with platelet transfusion, stopping eptifibatide, and interrupting dual antiplatelet therapy (DAPT).

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“…However, patients must be exposed to eptifibatide for 5–7 days before they develop sensitization when receiving it for the first time. EIT was reported in several case studies and occurred in approximately 1 to 2% of patients [ 109 , 110 , 111 , 112 , 113 , 114 ].…”

Section: Eptifibatidementioning

confidence: 99%

Eptifibatide, an Older Therapeutic Peptide with New Indications: From Clinical Pharmacology to Everyday Clinical Practice

Tonin

Klen

2023

IJMS

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Therapeutic peptides are oligomers or short polymers of amino acids used for various medical purposes. Peptide-based treatments have evolved considerably due to new technologies, stimulating new research interests. They have been shown to be beneficial in a variety of therapeutic applications, notably in the treatment of cardiovascular disorders such as acute coronary syndrome (ACS). ACS is characterized by coronary artery wall damage and consequent formation of an intraluminal thrombus obstructing one or more coronary arteries, leading to unstable angina, non-ST elevated myocardial infarction, and ST-elevated myocardial infarction. One of the promising peptide drugs in the treatment of these pathologies is eptifibatide, a synthetic heptapeptide derived from rattlesnake venom. Eptifibatide is a glycoprotein IIb/IIIa inhibitor that blocks different pathways in platelet activation and aggregation. In this narrative review, we summarized the current evidence on the mechanism of action, clinical pharmacology, and applications of eptifibatide in cardiology. Additionally, we illustrated its possible broader usage with new indications, including ischemic stroke, carotid stenting, intracranial aneurysm stenting, and septic shock. Further research is, however, required to fully evaluate the role of eptifibatide in these pathologies, independently and in comparison to other medications.

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Acute Profound Thrombocytopenia Induced by Eptifibatide Causing Diffuse Alveolar Hemorrhage

Cited by 4 publications

References 12 publications

A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

A woman with eptifibatide (integrilin)‐induced thrombocytopenia following treatment of a clot in her coronary artery: A case report and literature review

Eptifibatide-Induced Severe Thrombocytopenia After ST-Elevation Myocardial Infarction (STEMI): A Case Report

Eptifibatide, an Older Therapeutic Peptide with New Indications: From Clinical Pharmacology to Everyday Clinical Practice

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