American Journal of Cardiology
Volume 103, Issue 2 , Pages 175-180 , 15 January 2009

Thrombocytopenia in Patients With an Acute Coronary Syndrome (from the Global Registry of Acute Coronary Events [GRACE])

  • Joel M. Gore, MD

      Affiliations

    • University of Massachusetts Medical School, Worcester, Massachusetts
    • Corresponding Author InformationCorresponding author: Tel: 508-856-3871; fax: 508-856-4571
    • ,
  • Frederick A. Spencer, MD

      Affiliations

    • McMaster University, Hamilton, Ontario, Canada
    • ,
  • Enrique P. Gurfinkel, MD

      Affiliations

    • ICYCC Favaloro Foundation, Buenos Aires, Argentina
    • ,
  • José López-Sendón, MD

      Affiliations

    • Hospital Universitario LePaz, Madrid, Spain
    • ,
  • Ph. Gabriel Steg, MD

      Affiliations

    • INSERM U-698 and Université Paris VII Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
    • ,
  • Christopher B. Granger, MD

      Affiliations

    • Duke University Medical Center, Durham, North Carolina
    • ,
  • Gordon FitzGerald, PhD

      Affiliations

    • University of Massachusetts Medical School, Worcester, Massachusetts
    • ,
  • Giancarlo Agnelli, MD

      Affiliations

    • Department of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
    • ,
  • GRACE Investigators

Received 11 July 2008 ,Revised 22 August 2008 ,Accepted 22 August 2008.

References 

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  3. Warkentin TE, Levine MN, Hirsh J, Horsewood P, Roberts RS, Gent M, et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med. 1995;332:1330–1335
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  7. Berkowitz SD, Sane DC, Sigmon KN, Shavender JH, Harrington RA, Tcheng JE, et al. Occurrence and clinical significance of thrombocytopenia in a population undergoing high-risk percutaneous coronary revascularization (Evaluation of c7E3 for the Prevention of Ischemic Complications (EPIC) Study Group). J Am Coll Cardiol. 1998;32:311–319
  8. Dasgupta H, Blankenship JC, Wood GC, Frey CM, Demko SL, Menapace FJ. Thrombocytopenia complicating treatment with intravenous glycoprotein IIb/IIIa receptor inhibitors: a pooled analysis. Am Heart J. 2000;140:206–211
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  10. McClure MW, Berkowitz SD, Sparapani R, Tuttle R, Kleiman NS, Berdan LG, et al Clinical significance of thrombocytopenia during a non-ST-elevation acute coronary syndrome (The Platelet glycoprotein IIb/IIIa in UNSTAble angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial experience). Circulation. 1999;99:2892–2900
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  13. Steg PG, Goldberg RJ, Gore JM, Fox KA, Eagle KA, Flather MD, et al. Baseline characteristics, management practices, and in-hospital outcomes of patients hospitalized with acute coronary syndromes in the Global Registry of Acute Coronary Events (GRACE). Am J Cardiol. 2002;90:358–363
  14. Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP, et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events. Arch Intern Med. 2003;163:2345–2353
  15. Oliveira GB, Crespo EM, Becker RC, Honeycutt EF, Abrams CS, Anstrom KJ, et al Incidence and prognostic significance of thrombocytopenia in patients treated with prolonged heparin therapy. Arch Intern Med. 2008;168:94–102
  16. Brieger DB, Mak KH, Kottke-Marchant K, Topol EJ. Heparin-induced thrombocytopenia. J Am Coll Cardiol. 1998;31:1449–1459
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  18. The PURSUIT Trial Investigators. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy). N Engl J Med. 1998;339:436–443
  19. Huynh T, Piazza N, DiBattiste PM, Snapinn SM, Wan Y, Pharand C, et al. Analysis of bleeding complications associated with glycoprotein IIb/IIIa receptors blockade in patients with high-risk acute coronary syndromes: insights from the PRISM-PLUS study. Int J Cardiol. 2005;100:73–78
  20. Bougie DW, Wilker PR, Wuitschick ED, Curtis BR, Malik M, Levine S, et al. Acute thrombocytopenia after treatment with tirofiban or eptifibatide is associated with antibodies specific for ligand-occupied GPIIb/IIIa. Blood. 2002;100:2071–2076
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  25. Steg PG, Lopez-Sendon J, Lopez de Sa E, Goodman SG, Gore JM, Anderson FA, et al. External validity of clinical trials in acute myocardial infarction. Arch Intern Med. 2007;167:68–73

 The Global Registry of Acute Coronary Events (GRACE) is supported by an unrestricted educational grant from Sanofi-Aventis, Paris, France, to the Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts. Dr. Gore was supported by Sanofi-Aventis. Dr. Gurfinkel was supported by research/other grants from Sanofi-Aventis, Eli Lilly, Pasteur, and Schering; is on the Speakers' Bureau of Bristol-Myers Squibb; and a Consultant/Advisory Board member of the TIMI Group and Sanofi-Aventis. Dr. López-Sendón was supported by research grants from the TIMI Group, Sanofi-Aventis, Servier, BMS, and Amgem; received honoraria from Servier, Novartis, and Pfizer; and is a Consultant/Advisory Board member for Servier, Medtronic, Lilly, and CVT. Dr. Steg was supported by a research grant from Sanofi-Aventis; is on the Speakers Bureau for Boehringer Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Merck Sharp & Dohme, Novartis, Nycomed, Sanofi-Aventis, Sankyo, Servier, and ZLB-Behring; and is a Consultant/Advisory Board member of AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Merck Sharp & Dohme, Pfizer, Sanofi-Aventis, Servier, and Takeda. Dr. Granger was supported by Alexion, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, deCODE Genetics, Genentech, GlaxoSmithKline, Novartis, Proctor & Gamble, Sanofi-Aventis, The Medicines Company, INO Therapeutics, and Medicure. Giancarlo Agnelli was supported by Sanofi-Aventis.

PII: S0002-9149(08)01515-4

doi: 10.1016/j.amjcard.2008.08.055

American Journal of Cardiology
Volume 103, Issue 2 , Pages 175-180 , 15 January 2009

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