{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:27:49Z","timestamp":1780514869340,"version":"3.54.1"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":132,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Cardiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Background<\/jats:title>\n Profound thrombocytopenia after tirofiban exposure during primary percutaneous coronary intervention (PCI) is rare but clinically important. Causal attribution may be challenging when unfractionated heparin is coadministered, and the relevance of glucose\u20106\u2010phosphate dehydrogenase (G6PD) deficiency remains uncertain.<\/jats:p>\n <\/jats:sec>\n \n Case Presentation<\/jats:title>\n \n A 34\u2010year\u2010old man with known G6PD deficiency presented with an inferior ST\u2010segment elevation myocardial infarction and underwent primary PCI. He received aspirin, ticagrelor, and unfractionated heparin. Coronary angiography showed multivessel coronary disease with complete occlusion of the mid\u2010to\u2010distal right coronary artery and a large thrombus burden. After aspiration thrombectomy and drug\u2010eluting stent implantation, intracoronary tirofiban (2500\u2009\n \u03bc<\/jats:italic>\n g bolus), followed by intravenous tirofiban infusion (0.15\u2009\n \u03bc<\/jats:italic>\n g\/kg\/min), was administered as bailout antithrombotic therapy. Within 6\u2009h, the platelet count fell from 207 \u00d7 10\n 9<\/jats:sup>\n to 1 \u00d7 10\n 9<\/jats:sup>\n \/L. Peripheral blood smear showed no platelet clumping or abnormal cells. Sepsis and disseminated intravascular coagulation were not supported by laboratory findings. Heparin\u2010induced thrombocytopenia was considered highly unlikely because the 4Ts score was 1, reflecting the extremely early onset, absence of new thrombosis, and the presence of a more plausible alternative explanation. The clinical course was therefore most consistent with acute tirofiban\u2010associated profound thrombocytopenia.\n <\/jats:p>\n <\/jats:sec>\n \n Interventions and Outcomes<\/jats:title>\n \n Tirofiban and heparin were discontinued immediately, and intravenous immunoglobulin (20\u2009g\/day) was administered. The platelet count recovered to 25 \u00d7 10\n 9<\/jats:sup>\n \/L at 48\u2009h, 48 \u00d7 10\n 9<\/jats:sup>\n \/L at 72\u2009h, and 124 \u00d7 10\n 9<\/jats:sup>\n \/L on Day 4. Clopidogrel was restarted at 48\u2009h, followed by indobufen at 72\u2009h. No major bleeding or thrombotic complications occurred.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This case supports tirofiban\u2010associated acute profound thrombocytopenia as the most likely diagnosis and underscores the importance of prompt drug withdrawal, structured differential diagnosis against heparin\u2010induced thrombocytopenia, and individualized antithrombotic reinitiation. The contribution of G6PD deficiency remains hypothetical and requires further study.<\/jats:p>\n <\/jats:sec>","DOI":"10.1155\/cric\/3617791","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:55:37Z","timestamp":1778662537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tirofiban\u2010Associated Profound Thrombocytopenia in a Patient With Glucose\u20106\u2010Phosphate Dehydrogenase Deficiency Undergoing Primary Percutaneous Coronary Intervention: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0548-7573","authenticated-orcid":false,"given":"Chuanwei","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yansi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizhen","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yane","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2023.2233425"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1708111"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/20009666.2020.1747783"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-07-443051"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018024489"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.2_suppl.53S"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.279484"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-24-00757"}],"container-title":["Case Reports in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cric\/3617791","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cric\/3617791","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cric\/3617791","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:55:41Z","timestamp":1778662541000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cric\/3617791"}},"subtitle":[],"editor":[{"given":"Satabdi","family":"Datta Choudhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cric\/3617791"],"URL":"https:\/\/doi.org\/10.1155\/cric\/3617791","archive":["Portico"],"relation":{},"ISSN":["2090-6404","2090-6412"],"issn-type":[{"value":"2090-6404","type":"print"},{"value":"2090-6412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"3617791"}}