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    A practical guide to the management of immune thrombocytopenia co-existing with acute coronary syndrome

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    A-practical-guide-to-the-management-of-immune-thrombocytopenia-coexisting-with-acute-coronary-syndromeFrontiers-in-Medicine.pdf (526.4Kb)
    Date
    2024-01-01
    Author
    Rahhal, A.
    Provan, Drew
    Ghanima, Waleed
    González-López, Tomás José
    Shunnar, Khaled
    Najim, Mostafa
    Ahmed, Ashraf Omer
    Rozi, Waail
    Arabi, Abdulrahman
    Yassin, Mohamed
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    Abstract
    Introduction: Immune thrombocytopenia (ITP) management with co-existing acute coronary syndrome (ACS) remains challenging as it requires a clinically relevant balance between the risk and outcomes of thrombosis and the risk of bleeding. However, the literature evaluating the treatment approaches in this high-risk population is scarce. Methods and Results: In this review, we aimed to summarize the available literature on the safety of ITP first- and second-line therapies to provide a practical guide on the management of ITP co-existing with ACS. We recommend holding antithrombotic therapy, including antiplatelet agents and anticoagulation, in severe thrombocytopenia with a platelet count < 30 × 109/L and using a single antiplatelet agent when the platelet count falls between 30 and 50 × 109/L. We provide a stepwise approach according to platelet count and response to initial therapy, starting with corticosteroids, with or without intravenous immunoglobulin (IVIG) with a dose limit of 35 g, followed by thrombopoietin receptor agonists (TPO-RAs) to a target platelet count of 200 × 109/L and then rituximab. Conclusion: Our review may serve as a practical guide for clinicians in the management of ITP co-existing with ACS.
    URI
    https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85191234139&origin=inward
    DOI/handle
    http://dx.doi.org/10.3389/fmed.2024.1348941
    http://hdl.handle.net/10576/61881
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    • Medicine Research [‎1739‎ items ]

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