Archives of the Turkish Society of Cardiology
A practical and case-based approach to thrombocytopenia in cardiology practice [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2018; 46(2): 155-162 | DOI: 10.5543/tkda.2018.76968

A practical and case-based approach to thrombocytopenia in cardiology practice

Erman Öztürk1, Ferit Onur Mutluer2
1Department of Hematology, Koç University Faculty of Medicine, İstanbul, Turkey
2Department of Cardiology, Koç University Faculty of Medicine, İstanbul, Turkey

In cardiology practice, anticoagulation and antiplatelet therapies are essential for most patients. As of yet, there is no high quality evidence regarding these treatments in thrombocytopenic patients, which continues to be an issue. Thrombocytopenia is defined as a platelet count of <150x109/L and is classified as severe when the platelet count is <50x109/L. Pseudothrombocytopenia, drug-induced thrombocytopenia, immune thrombocytopenia, heparin-induced thrombocytopenia, and thrombotic thrombocytopenic purpura are some of the main causes of thrombocytopenia. The current treatment suggestions are conservative, as a result of the lack of evidence, built on defensive treatment strategies and the fear of bleeding complications. Many patients with acute myocardial infarction with thrombocytopenia have undergone percutaneous coronary intervention successfully with adjunctive antiplatelet and anticoagulant use, as has been described in case reports. A risk-benefit ratio should be evaluated for antiplatelet therapy. In the relevant guidelines, while full dose low-molecular-weight heparin (LMWH) is recommended for patients with a thrombocyte count of >50x109/L, a half-dose of LMWH is recommended in patients with thrombocytopenia between 25 and 50x109/L. According to the current guidelines, avoiding antiplatelet and anticoagulant treatment should be restricted to patients with very severe thrombocytopenia (i.e., a platelet count <25x109/L), but new data and recommendations are needed.

Keywords: Anticoagulant, antiplatelet; cardiology; heparin induced thrombotic thrombocytopenia; immune thrombocytopenic purpura; thrombocytopenia.

How to cite this article
Erman Öztürk, Ferit Onur Mutluer. A practical and case-based approach to thrombocytopenia in cardiology practice. Turk Kardiyol Dern Ars. 2018; 46(2): 155-162

Corresponding Author: Erman Öztürk, Türkiye
© Copyright 2018 Archives of the Turkish Society of Cardiology
LookUs & Online Makale