| Use of platelet glycoprotein IIb/IIIa inhibitors and spontaneous pulmonary hemorrhage. | |
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MedLine Citation:
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PMID: 12668843 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The use of platelet glycoprotein (GP) IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention has resulted in an impressive reduction in adverse events. Pulmonary hemorrhage is a rare but potentially lethal complication of antithrombotic and antiplatelet therapy. We analyzed the incidence of spontaneous pulmonary hemorrhage following the use of platelet GP IIb/IIIa inhibitors. METHODS: The medical records of 1,020 consecutive patients who received GP IIb/IIIa inhibitors and underwent PCI at our institution between August 1997 and December 1999 were reviewed. RESULTS: Diffuse pulmonary hemorrhage developed in 7 patients (0.68%), two of whom died. Five of 7 patients with pulmonary hemorrhage had activated clotting times > 250 seconds during the procedure. Activated partial thromboplastin time measured at the time of pulmonary hemorrhage was elevated in all patients (mean, 85 seconds; range, 69 95 seconds). All patients had history of congestive heart failure and had elevated pulmonary capillary wedge pressure and/or left ventricular end-diastolic pressure at the time of the index procedure. Six patients also had evidence of baseline radiographic abnormalities. CONCLUSION: Diffuse pulmonary hemorrhage is a potentially disastrous complication of GP Ilb/Illa antagonists. No specific predictors can be identified, but evidence of pulmonary congestion, baseline pulmonary abnormalities and use of higher heparin dosages may predispose patients to this serious complication. |
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Authors:
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Arshad Ali; Mustafa Hashem; Howard S Rosman; Ghassan Kazmouz; Julius M Gardin; Theodore L Schrieber |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 15 ISSN: 1042-3931 ISO Abbreviation: J Invasive Cardiol Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-01 Completed Date: 2003-06-11 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 186-8 Citation Subset: IM |
Affiliation:
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Division of ardiology, St Johns Hospital & Medical Center, Detroit, MI, USA. arshadali@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Antibodies, Monoclonal / adverse effects Female Hemorrhage / chemically induced*, epidemiology Humans Immunoglobulin Fab Fragments / adverse effects Incidence Lung Diseases / chemically induced*, epidemiology Male Michigan / epidemiology Middle Aged Peptides / adverse effects, antagonists & inhibitors Platelet Aggregation Inhibitors / adverse effects* Platelet Glycoprotein GPIIb-IIIa Complex / adverse effects*, antagonists & inhibitors* Pulmonary Wedge Pressure / drug effects Treatment Failure Tyrosine / adverse effects, analogs & derivatives, antagonists & inhibitors Ventricular Pressure / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Peptides; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/eptifibatide; 143653-53-6/abciximab; 144494-65-5/tirofiban; 55520-40-6/Tyrosine |
| Comments/Corrections | |
Comment In:
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J Invasive Cardiol. 2003 Apr;15(4):189-90
[PMID:
12668844
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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