Korean Circ J.  2013 Aug;43(8):557-560. 10.4070/kcj.2013.43.8.557.

Acute Profound Thrombocytopenia after Using Abciximab for No-Reflow during Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction

• Park S
• Lee J
• Lee SY
• Bae JW
• Hwang KK
• Kim DW
• Cho MC
• Kim SM

• KMID: 2224846
• DOI: http://doi.org/10.4070/kcj.2013.43.8.557

Abstract

Glycoprotein IIb/IIIa antagonists are well established for their effectiveness in improving clinical outcomes in acute coronary syndrome patients undergoing percutaneous coronary intervention. Acute profound thrombocytopenia is a rare complication of abciximab. We present a case which was managed successfully for the rare complication of acute profound thrombocytopenia after using abciximab and an intra-aortic balloon pump for the treatment of a no-reflow phenomenon and consecutive cardiogenic shock during primary percutaneous coronary intervention.

Keyword

Thrombocytopenia; Abciximab; No-reflow phenomenon

MeSH Terms

Acute Coronary Syndrome
Antibodies, Monoclonal
Humans
Immunoglobulin Fab Fragments
Myocardial Infarction
No-Reflow Phenomenon
Percutaneous Coronary Intervention
Shock, Cardiogenic
Thrombocytopenia
Antibodies, Monoclonal
Immunoglobulin Fab Fragments

Figure

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  Fig. 1 Findings of coronary angiography and primary percutaneous coronary intervention. A and B: no specific stenosis in the left coronary artery. C: a totally occluded lesion of the proximal RCA with collateral flow grade 1 from LAD. D: a bare metal stent was implanted in the proximal RCA lesion. E: after implantation of a stent, the coronary angiogram shows no-reflow phenomenon. The arrowindicates the implanted stent. F: improvement of TIMI flow grade from grade 0 to grade 3 after intracoronary injection of nitrate and adenosine, and intravenous injection of abciximab. LAD: left anterior descending artery, RCA: right coronary artery, TIMI: Thrombolysis in Myocardial Infarction.

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  Fig. 2 The course of platelet count after bolus administration of abciximab decreased, and then gradually increased after cessation of heparin and transfusion of platelet concentration.

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