Clinical observation and intervention analysis of patients with severe thrombocytopenia induced by tirofiban

Abstract

Abstract Background There have been individual cases of successful treatment of tirofiban-induced thrombocytopenia by immunosuppressive agents (glucocorticoids and/or immunoglobulin), but no relevant case-control studies. This is a single-center, retrospective, case‒control study to observe the clinical characteristics of patients with severe thrombocytopenia induced by tirofiban and the intervention effect of immunosuppressive agents.Method 29 patients with severe thrombocytopenia induced by tirofiban during hospitalization in the Cardiology Department of our hospital from September 2008 to September 2021 were retrospectively observed. The patients were divided into 2 groups according to age. The elderly group included patients aged ≥ 60 years, with a total of 18 patients; the nonelderly group included patients aged༜60 years, with a total of 11 patients. Furthermore, the patients were divided into 2 groups according to whether they took immunosuppressive agents.The differences between the groups were compared between the lowest value of platelet levels, the time required for the platelet count to return to the normal range(≥100×109/L) after treatment, and the proportion of various bleeding events.Results There was no significant difference in the baseline value, the lowest value of platelet count, or the time required for the platelet count to return to the normal range between the elderly group and the nonelderly group (p > 0.05). In the elderly subgroup, there was no significant difference in the baseline value and the lowest value of platelet count between the treatment group and the control group (p > 0.05). However, the time required for the platelet count to return to the normal range in the treatment group was significantly shorter than that in the control group (p < 0.05). There were no significant differences in the various bleeding events between the elderly patients and nonelderly patients, or between the immunosuppressant treatment group and the control group in both elderly and nonelderly patients (p > 0.05).Conclusion immunosuppressive agents significantly shorten the time to normalization of the platelet count in elderly patients with tirofiban-induced severe thrombocytopenia; the bleeding risk in patients with tirofiban-induced severe thrombocytopenia does not increase with age.