Incidence of thrombocytopenia following coronary stent placement using abciximab plus clopidogrel or ticlopidine

The incidence of thrombocytopenia with ticlopidine and clopidogrel when use d in conjunction with abciximab has not been systematically addressed. We e valuated the rate of thrombocytopenia in patients undergoing intracoronary stent implantation receiving bolus plus infusion of abciximab and either ti clopidine or clopidogrel. We noted an incidence of 24% with the combination of 300-mg clopidogrel and abciximab, Other doses of ticlopidine (250 and 5 00 mg) and clopidogrel (75 mg) did not result in a statistically significan t increase in thrombocytopenia over that of the 2.5%-5.2% reported incidenc e with abciximab alone. Length of hospital stay was 2.3 vs. 6.4 days in tho se developing thrombocytopenia (P = 0.06). Four (25%) developed thrombocyto penia requiring blood transfusion. Eight (50%) had no sequelae, The combina tion of 300-mg clopidogrel and abciximab results in a significant increase in the incidence of thrombocytopenia. This is an important clinical observa tion that merits further study. Cathet. Cardiovasc. Intervent. 50:426-430, 2000. (C) 2000 Wiley-Liss, Inc.