CASE REPORT article
Front. Pharmacol.
Sec. Cardiovascular and Smooth Muscle Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1618693
Acute Myocardial Infarction Induced by Avatrombopag: A Case Report
Provisionally accepted
- Department of Traditional Chinese Medicine, Chengdu Fifth People's Hospital, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: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. Summary:A 58-year-old female with steroid-refractory ITP developed ST-elevation myocardial infarction (STEMI) five days after initiating avatrombopag monotherapy (20 mg/day). She had no history of traditional cardiovascular risk factors. Her platelet count increased from 2 to 122 × 10 ⁹ /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 × 10 ⁹ /L), requiring avatrombopag re-initiation alongside aspirin. No further thrombosis occurred. Conclusion:Avatrombopag monotherapy may induce rapid coronary thrombosis. Prophylactic antiplatelet therapy and maintaining platelets at 50-150 × 10⁹/L are critical during TPO-RA treatment. This case highlights the need for thrombotic risk assessment before TPO-RA initiation.
Keywords: Avatrombopag, acute myocardial infarction, Coronary Thrombosis, immune thrombocytopenia, thrombopoietin receptor agonists
Received: 26 Apr 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Gou, Liu, Lang and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fengyouy Yao, Department of Traditional Chinese Medicine, Chengdu Fifth People's Hospital, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.