Vol 62, No 1 (2005)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Profound thrombocytopenia after abciximab administration in acute myocardial infarction and stent thrombosis following thrombocytopenia remission - a case report

Waldemar Elikowski, Janusz Rzeźniczak, Marek Słomczyński, Piotr Psuja
Kardiol Pol 2005;62(1):44-47.
Vol 62, No 1 (2005)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Profound thrombocytopenia after abciximab administration in acute myocardial infarction and stent thrombosis: This article presents a case of a 62-years-old man with acute anterior myocardial infarction, treated with PCI and stent implantation, in whom profound acute thrombocytopenia was observed after abciximab administration. Nadir platelet count was 6 G/L (before treatment: 250 G/L). Pseudothrombocytopenia was excluded. The remaining antiplatelet drugs (heparin, ASA, clopidogrel) were discontinued. There were no symptoms of bleeding, but next morning (platelet count: 14 G/L) a gross hematoma at femoral puncture site was observed. The patient received 5 U transfusion of platelets. On the 4th day, when the platelet count reached 64 G/L, he was started again on ASA (150 mg) and clopidogrel (75 mg). On the 7th day (platelet count: 138 G/L) he developed anterior ischemia and stent reocclusion was diagnosed. After p.o. clopidogrel (300 mg), balloon PCI with i.c. heparin was performed and ischemia symptoms subsided. The platelet value before the patient's discharge, on subsequent therapy with ASA and clopidogrel, increased to 300 G/L. A review of current literature on this topic is provided.

Abstract

Profound thrombocytopenia after abciximab administration in acute myocardial infarction and stent thrombosis: This article presents a case of a 62-years-old man with acute anterior myocardial infarction, treated with PCI and stent implantation, in whom profound acute thrombocytopenia was observed after abciximab administration. Nadir platelet count was 6 G/L (before treatment: 250 G/L). Pseudothrombocytopenia was excluded. The remaining antiplatelet drugs (heparin, ASA, clopidogrel) were discontinued. There were no symptoms of bleeding, but next morning (platelet count: 14 G/L) a gross hematoma at femoral puncture site was observed. The patient received 5 U transfusion of platelets. On the 4th day, when the platelet count reached 64 G/L, he was started again on ASA (150 mg) and clopidogrel (75 mg). On the 7th day (platelet count: 138 G/L) he developed anterior ischemia and stent reocclusion was diagnosed. After p.o. clopidogrel (300 mg), balloon PCI with i.c. heparin was performed and ischemia symptoms subsided. The platelet value before the patient's discharge, on subsequent therapy with ASA and clopidogrel, increased to 300 G/L. A review of current literature on this topic is provided.
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Keywords

thrombocytopenia - abciximab - pci - myocardial infarction - stent thrombosis

About this article
Title

Profound thrombocytopenia after abciximab administration in acute myocardial infarction and stent thrombosis following thrombocytopenia remission - a case report

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 62, No 1 (2005)

Pages

44-47

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2005;62(1):44-47.

Keywords

thrombocytopenia - abciximab - pci - myocardial infarction - stent thrombosis

Authors

Waldemar Elikowski
Janusz Rzeźniczak
Marek Słomczyński
Piotr Psuja

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