Thrombocytopenia associated with c7E3 Fab (abciximab)

D. A. Schell, Apar Kishor P Ganti, R. Levitt, A. Potti

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Abciximab (c7E3 Fab) inhibits platelet aggregation and is used to prevent complications of percutaneous coronary intervention. Thrombocytopenia is an often-cited complication of abciximab. Pseudothrombocytopenia is due to ethylenediaminetetraacetate (EDTA)-activated platelet agglutination, resulting in a spuriously low platelet count. We have looked at both "true" and pseudothrombocytopenia after infusion of abciximab. Sixty-six patients receiving their first exposure to abciximab after an unstable coronary event/revascularization were eligible. All the patients received a bolus of c7E3 Fab followed by a continuous infusion. Platelets were monitored in all patients at 2, 4, 12, 24, and 48 h, and more frequently if required. The incidence of thrombocytopenia and acute severe thrombocytopenia (platelet count ≤20,000/μl) was evaluated. A peripheral blood smear was performed on all patients showing thrombocytopenia to evaluate for pseudothrombocytopenia. Seventeen (25.6%) developed thrombocytopenia and nine (13.6%) developed acute severe thrombocytopenia. However, 18 of these patients had pseudothrombocytopenia. The onset of true thrombocytopenia was at 4 h after the infusion, while pseudothrombocytopenia occurred at anytime during the first 24 h. Only two (3.03%) patients required platelet transfusions. No life-threatening hemorrhagic complications were recognized. Five of six subjects with true thrombocytopenia had positive laboratory findings of disseminated intravascular coagulation; however, none had an adverse outcome. Acute severe thrombocytopenia was noted to be a relatively benign adverse effect of abciximab. There is an increasing incidence of pseudothrombocytopenia in this subgroup of patients. It would be worthwhile examining a peripheral blood smear or collecting blood for platelet counts in a heparin-coated tube in order to exclude this phenomenon and thereby prevent inappropriate discontinuation of this drug.

Original languageEnglish (US)
Pages (from-to)76-79
Number of pages4
JournalAnnals of Hematology
Volume81
Issue number2
DOIs
StatePublished - Dec 1 2002
Externally publishedYes

Fingerprint

Thrombocytopenia
Platelet Count
Blood Platelets
abciximab
Platelet Transfusion
Disseminated Intravascular Coagulation
Incidence
Agglutination
Percutaneous Coronary Intervention
Platelet Aggregation
Heparin
Pharmaceutical Preparations

Keywords

  • Pseudothrombocytopenia
  • Thrombocytopenia
  • c7E3 fab (abciximab)

ASJC Scopus subject areas

  • Hematology

Cite this

Thrombocytopenia associated with c7E3 Fab (abciximab). / Schell, D. A.; Ganti, Apar Kishor P; Levitt, R.; Potti, A.

In: Annals of Hematology, Vol. 81, No. 2, 01.12.2002, p. 76-79.

Research output: Contribution to journalArticle

Schell, D. A. ; Ganti, Apar Kishor P ; Levitt, R. ; Potti, A. / Thrombocytopenia associated with c7E3 Fab (abciximab). In: Annals of Hematology. 2002 ; Vol. 81, No. 2. pp. 76-79.
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