Acute Life-Threatening Glycoprotein IIb/IIIa Inhibitor-Induced Thrombocytopenia Following Percutaneous Coronary Intervention (PCI): A Case Report and Review of the Literature

Most patients who undergo percutaneous coronary intervention (PCI) to address coronary artery disease receive antiplatelets and anticoagulants to lower the risk of postoperative thrombotic events. Tirofiban, a glycoprotein IIb/IIIa inhibitor (GPI), has demonstrated remarkable efficacy in reducing morbidity and mortality rates in PCI postoperative care. However, it is crucial to be vigilant about potential complications associated with tirofiban, particularly thrombocytopenia. Thrombocytopenia is a serious complication that requires close monitoring of the patients' platelet count after initiation of the therapy. Regularly monitoring levels in two- to six-hour increments during the initial 24-48 hours after exposure can detect most cases of acute and potentially life-threatening thrombocytopenia. Prompt discontinuation of GPI and timely implementation of other supportive measures can help prevent further adverse events. We present a case of a 70-year-old male who presented to the Emergency Department with chest pain. Following a thorough evaluation, the patient underwent angiography, during which stent placement was performed. Administration of tirofiban resulted in profound thrombocytopenia, with platelets decreasing to 1 g/L within 24 hours. Tirofiban was promptly withdrawn, and a platelet transfusion was initiated in order to stabilize the patient's platelet level.