Thrombocytopenia associated with the use of GPIIb/IIIa inhibitors: position paper of the ISTH working group on thrombocytopenia and GPIIb/IIIa inhibitors.

摘要

GPIIb/IIIa inhibitors are known to reduce the incidence of adverse complications after coronary angioplasty by inhibiting the reaction of fibrinogen with the activated platelets, and are now widely used. Acute thrombocytopenia is a recognized side effect of the three clinically approved inhibitors - tirofiban and eptifibatide, synthetic compounds that mimic or contain the Ang-Gly-Asp (RGD) peptide and bind tightly to the RGD recognition site in GPIIb/llla, and abciximab, a chimeric Fab fragment specific for an epitope on GPIIIa. Although most patients experiencing thrombocytopenia after treatment with these drugs recover uneventfully, severe bleeding and fatalities have been described. Here, we review the clinical presentation, pathogenesis, and diagnosis of this disorder, and highlight the unresolved issues that deserve further study.