Document Detail


Use of platelet glycoprotein IIb/IIIa inhibitors and spontaneous pulmonary hemorrhage.
MedLine Citation:
PMID:  12668843     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Arshad Ali; Mustafa Hashem; Howard S Rosman; Ghassan Kazmouz; Julius M Gardin; Theodore L Schrieber
Related Documents :
18300883 - Recurrent subarachnoid hemorrhage caused by a de novo basilar tip aneurysm developing w...
548573 - Considerations on the origin of subarachnoid hemorrhages.
20934653 - Value of duplex scanning in differentiating embolic from thrombotic arterial occlusion ...
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    
Affiliation:
Division of ardiology, St Johns Hospital & Medical Center, Detroit, MI, USA. arshadali@aol.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
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
Comments/Corrections
Comment In:
J Invasive Cardiol. 2003 Apr;15(4):189-90   [PMID:  12668844 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  A technique for type 4a coronary bifurcation lesions: initial results and 6-month clinical evaluatio...
Next Document:  Arterial wall temperature following coronary stent implantation in pigs: the role of post-stent infl...