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A Case Report of Ticagrelor-Induced Thrombocytopenia

Overview
Publisher Dove Medical Press
Specialty General Medicine
Date 2023 Jul 10
PMID 37426310
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Abstract

Introduction: We report a case of new-onset thrombocytopenia following administration of a loading dose of ticagrelor.

Case Presentation: A 66-year-old male known to have diabetes mellitus type II, chronic obstructive airway disease, and hypertension presented to the emergency department with retrosternal chest pain and dyspnea. Work-up on presentation showed Hb 14.7 g/dL, platelet 229 × 10/L, and troponin 309 ng/mL. The electrocardiogram showed ST elevation in the anterior-lateral leads. The patient underwent balloon angioplasty, and a drug-eluting stent was deployed. During the procedure, intravenous unfractionated heparin and a 180 mg loading dose of ticagrelor were given. Six hours post procedure, the platelet count was 70 × 10/L without active bleeding. Blood smear was unremarkable, and no schistocytes could be seen. So, ticagrelor was stopped, and the patient's platelet count completely recovered four days after discontinuation.

Conclusion: Ticagrelor-induced thrombocytopenia is a rare but increasingly recognized entity. Therefore, post-treatment monitoring and early recognition are crucial parts of management.

References
1.
Ahmed I, Majeed A, Powell R . Heparin induced thrombocytopenia: diagnosis and management update. Postgrad Med J. 2007; 83(983):575-82. PMC: 2600013. DOI: 10.1136/pgmj.2007.059188. View

2.
Khan M, Adhikari G, Khan H, Changezi H . A case report of absolute thrombocytopenia with ticagrelor. Eur Heart J Case Rep. 2020; 4(4):1-5. PMC: 7501937. DOI: 10.1093/ehjcr/ytaa169. View

3.
Dogan A, Ozdemir B, Bal H, Ozdemir E, Kurtoglu N . Ticagrelor-associated thrombotic thrombocytopenic purpura. Anatol J Cardiol. 2017; 17(1):73-74. PMC: 5324867. DOI: 10.14744/AnatolJCardiol.2017.7426. View

4.
Kowalczyk M, Banach M, Mikhailidis D, Hannam S, Rysz J . Ticagrelor--a new platelet aggregation inhibitor in patients with acute coronary syndromes. An improvement of other inhibitors?. Med Sci Monit. 2009; 15(12):MS24-30. View

5.
McCarthy C, Steg G, Bhatt D . The management of antiplatelet therapy in acute coronary syndrome patients with thrombocytopenia: a clinical conundrum. Eur Heart J. 2017; 38(47):3488-3492. PMC: 5837661. DOI: 10.1093/eurheartj/ehx531. View