Abstract
Glycoprotein IIb/IIIa inhibitors represent a new promising class of antiplatelet medications. Their use in acute coronary syndromes and for patients undergoing percutaneous coronary intervention has been the subject of a number of large controlled trials using both the intravenous and the oral forms. In this review, we present a systematic overview of these trials.
Highlights
Platelets play a pivotal role in acute coronary syndromes [1,2]
We summarize the trials conducted to evaluate the use of GP IIb/IIIa inhibitors in these clinical settings, and discuss issues of efficacy and safety
Percutaneous coronary interventions The role of periprocedural intravenous GP IIb/IIIa inhibition in percutaneous coronary revascularization was established in nine placebo-controlled randomized trials and one comparative trial enrolling, in total, over 24,000
Summary
Intravenous GP IIb/IIIa inhibition used as an adjunct to percutaneous coronary interventions results in significant reduction in early ischemic events that may be sustained for 1 year. This benefit is independent of the interventional devices used and independent of lesion complexities. IIb/IIIa inhibition may be a useful adjunct to conventional thrombolytic therapy by accelerating the process of fibrinolysis. This awaits confirmatory evidence on the efficacy and safety of this combination regimen from ongoing megatrials. IIb/IIIa inhibitors, oral GP IIb/IIIa inhibitors were associated with a significant increase in mortality. Further investigation to elucidate the cause of this increased fatality risk is warranted
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