[Current approach in antithrombotic treatment during coronary interventions: specific thrombocyte aggregation inhibitors and direct thrombin antagonists in high-risk patients].
Patients undergoing angioplasty (PTCA) for unstable angina, postinfarction angina, or complex coronary lesions represent a high risk group for ischemic complications. High dose heparin and aspirin are used routinely to prevent thrombotic complications. However, new approaches designed to avoid platelet aggregation, including development of specific platelet GP IIb/IIIa receptor antagonists and specific thrombin inhibitors, demonstrate a significant reduction of thrombotic events following coronary interventions compared to heparin alone. Bleeding complications are not increased if conjunctive heparin administration is weight-adjusted. Pathophysiology of acute coronary closure, mechanisms of action of the new anti-thrombotic drugs, and current and future clinical applications are discussed.
Meyer
B J
BJ
Departement Innere Medizin, Inselspital Bern.
D000293:Adolescent; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use*; D000991:Antithrombins / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006493:Heparin / Q000627:therapeutic use*; D006629:Hirudins / Q000008:administration & dosage; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D019038:Platelet Glycoprotein GPIb-IX Complex; D010980:Platelet Membrane Glycoproteins; D011183:Postoperative Complications / Q000517:prevention & control*; D011956:Receptors, Cell Surface / Q000037:antagonists & inhibitors; D012307:Risk Factors; D013927:Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants; D000991:Antithrombins; D006629:Hirudins; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019038:Platelet Glycoprotein GPIb-IX Complex; D010980:Platelet Membrane Glycoproteins; D011956:Receptors, Cell Surface; C032193:glycoprotein receptor GPIb-IX; D006493:Heparin; D001241:Aspirin