Severe Thrombocytopenia Associated with Low dose of Intracoronary Tirofiban

Tirofiban is a glycoprotein IIb/IIIa inhibitor and is an adjunct in the treatment of patients with acute coronary syndrome. Its main side effects are bleeding and thrombocytopenia. Severe thrombocytopenia is a rare but serious complication of tirofiban therapy, including when administered at low intracoronary doses in interventional cardiac procedures. The pathogenesis is largely immune-mediated and can result in abrupt and profound platelet count declines. Early and frequent platelet monitoring, prompt discontinuation of the drug, and supportive care remain critical to managing this adverse effect. In this case report, we present a case of severe thrombocytopenia that occurred in a 74-year-old male patient with non-ST segment elevation myocardial infarction following administration of a very low dose of tirofiban.