{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:10:20Z","timestamp":1756282220910,"version":"3.44.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Avatrombopag, a thrombopoietin receptor agonist (TPO-RA), is used for immune thrombocytopenia (ITP) but confers thrombotic risks. Acute myocardial infarction (AMI) as an adverse event is underreported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>A 58-year-old female with steroid-refractory ITP developed ST-elevation myocardial infarction (STEMI) 5\u00a0days after initiating avatrombopag monotherapy (20\u00a0mg\/day). She had no history of traditional cardiovascular risk factors. Her platelet count increased from two to 122 \u00d7 10<jats:sup>9<\/jats:sup>\/L before AMI. Coronary angiography revealed thrombotic occlusion of the left ventricular posterior branch, treated with thrombus aspiration. Dual antiplatelet therapy was initiated, and avatrombopag was discontinued. The patient was discharged on day 10 post-AMI. At the 14-day follow-up, thrombocytopenia recurred (platelets 18 \u00d7 10<jats:sup>9<\/jats:sup>\/L), requiring avatrombopag re-initiation alongside aspirin. No further thrombosis occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Avatrombopag monotherapy may induce rapid coronary thrombosis. Prophylactic antiplatelet therapy and maintaining platelets at 50\u2013150 \u00d7 10<jats:sup>9<\/jats:sup>\/L are critical during TPO-RA treatment. This case highlights the need for thrombotic risk assessment before TPO-RA initiation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1618693","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T04:10:32Z","timestamp":1755835832000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute myocardial infarction induced by avatrombopag: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Gou","family":"Junqi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liu","family":"Chaohui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lang","family":"Mingjian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Fengyou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"518","DOI":"10.3390\/hematolrep15030054","article-title":"Thrombotic complications in immune thrombocytopenia patients treated with avatrombopag","volume":"15","author":"Abdelsamia","year":"2023","journal-title":"Hematol. 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