Document Detail

Use of platelet glycoprotein IIb/IIIa inhibitors and spontaneous pulmonary hemorrhage.
MedLine Citation:
PMID:  12668843     Owner:  NLM     Status:  MEDLINE    
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.
Arshad Ali; Mustafa Hashem; Howard S Rosman; Ghassan Kazmouz; Julius M Gardin; Theodore L Schrieber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  15     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-01     Completed Date:  2003-06-11     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  186-8     Citation Subset:  IM    
Division of ardiology, St Johns Hospital & Medical Center, Detroit, MI, USA.
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MeSH Terms
Antibodies, Monoclonal / adverse effects
Hemorrhage / chemically induced*,  epidemiology
Immunoglobulin Fab Fragments / adverse effects
Lung Diseases / chemically induced*,  epidemiology
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
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Peptides; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/eptifibatide; 144494-65-5/tirofiban; 55520-40-6/Tyrosine; X85G7936GV/abciximab
Comment In:
J Invasive Cardiol. 2003 Apr;15(4):189-90   [PMID:  12668844 ]

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