Format

Send to:

Choose Destination
See comment in PubMed Commons below
Curr Cardiol Rev. 2008 May;4(2):84-91. doi: 10.2174/157340308784245793.

The Role of Glycoprotein IIb/IIIa Inhibitors- A Promise Not Kept?

Author information

  • 1Department of Cardiology, University Medical Center, University of Medicine and Dentistry, Newark, NJ, USA.

Abstract

For over one decade Glycoproteins IIb/IIIa inhibitors (GPI) have been administered to prevent coronary artery thrombosis. Initially these agents were used for acute coronary syndromes and subsequently as adjunctive pharmacotherapy for percutaneous coronary interventions (PCIs). MOST BENEFIT OF GPI EMERGED FROM REDUCTION OF ISCHEMIC EVENTS: mostly non-q-wave myocardial infarctions (NQWMIs) during PCI. However, individual randomized clinical trials could not demonstrate that any of these agents could significantly reduce mortality in any clinical subset of patients. Studies of employing prolonged oral GPI administration resulted in excessive death. The non-homogenous statistically-significant reduction of ischemic endpoints was accompanied by an excess of bleeding, vascular complications, and thrombocytopenia. The clinical and ecomomic burden of major bleeding and thrombocytopenia is substantial. The ACUITY trial has initiate a new debate regarding the efficacy and safety of GPI. Selective "patient-tailored" use of GPI limited to moderate-high risk PCI patients with low bleeding propensity is suggested. Research of new algorithms emphasizing abbreviated GPI administration, careful access site and bleeding surveillance, in conjunction with lower doses of unfractionated heparin or new and safer anti-thrombins may further enhance patient safety.

PMID:
19936282
[PubMed]
PMCID:
PMC2779356
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Bentham Science Publishers Ltd. Icon for PubMed Central
    Loading ...
    Write to the Help Desk