Novel antiplatelet therapies for treatment of patients with ischemic heart disease: inhibitors of the platelet glycoprotein IIb/IIIa integrin receptor.
Blood platelets play essential roles in normal coagulation and in coronary atherosclerotic disease and its complications. Various antiplatelet therapies, including aspirin, ticlopidine, and dipyridamole, have been developed for use in patients with known coronary artery artery disease to prevent ischemic complications. More recently a more complete anti-aggregation effect has been accomplished by the use of monoclonal antibodies and specific peptide and nonpeptide compounds that bind to the platelet GP IIb/IIIa surface receptor. This receptor becomes activated by platelet stimulation and binds fibrinogen molecules between platelets in the aggregation process. These new antiplatelet drugs are now being evaluated in clinical trials in patients undergoing balloon coronary angioplasty, in whom fewer ischemic events occur when the receptor blocker is used intravenously than with standard therapy, and in patients with stable and unstable angina. Excessive bleeding is an important problem with these agents, and efforts must be made to eliminate this side effect.
Frishman
W H
WH
Department of Medicines, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA.
Burns
B
B
Atac
B
B
Alturk
N
N
Altajar
B
B
Lerrick
K
K
D000077284:Abciximab; D000595:Amino Acid Sequence; D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D001241:Aspirin / Q000627:therapeutic use; D019483:Disintegrins; D005343:Fibrinolytic Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000494:pharmacology / Q000627:therapeutic use; D008698:Mesylates / Q000494:pharmacology / Q000627:therapeutic use; D008969:Molecular Sequence Data; D017202:Myocardial Ischemia / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D010455:Peptides / Q000494:pharmacology / Q000627:therapeutic use; D010456:Peptides, Cyclic / Q000494:pharmacology / Q000627:therapeutic use; D015539:Platelet Activation / Q000187:drug effects / Q000502:physiology*; D010973:Platelet Adhesiveness / Q000187:drug effects / Q000502:physiology; D010974:Platelet Aggregation / Q000187:drug effects / Q000502:physiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors* / Q000737:chemistry / Q000502:physiology; D013927:Thrombosis / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology
D000911:Antibodies, Monoclonal; D019483:Disintegrins; D005343:Fibrinolytic Agents; D007140:Immunoglobulin Fab Fragments; D008698:Mesylates; D010455:Peptides; D010456:Peptides, Cyclic; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; C085286:DMP 728; D001241:Aspirin; D000077284:Abciximab