Glycoprotein IIbIIIa Inhibitors in ACS with PCI

Abstract

The ACC/AHA pocket guideline (November 2002) for the management of ACS distributed to physicians nationwide has a class I recommendation that a platelet glycoprotein IIbIIIa (GP2b3a) antagonist should be administered to patients undergoing PCI. This recommendation is given without qualification or “as planned” or “not planned.” This is incredible given the fact that there are little prospective data on the use of GP2b3aIs in ACS with PCI! GP2b3aIs have been studied primarily in ACS without PCI (“medical management”) and non-ACS PCI (“elective stent”). The data that do exist on ACS with PCI suffers from outmoded therapies, non-randomized data, and retrospective data collection predominantly from “unstable angina” patients