Preferential benefit of platelet glycoprotein IIb/IIIa receptor blockade: specific considerations by device and disease state.
Several patient subgroups appear to benefit preferentially from inhibition of platelet glycoprotein (GP) IIb/IIa receptors. In clinical trials the GP IIb/IIa blocker abciximab (ReoPro; Lilly) proved both safe and effective in improving outcomes after coronary interventions. Endpoints of death, myocardial infarction (MI), and need for urgent intervention were significantly decreased in a randomized placebo-controlled trial of patients treated with abciximab in conjunction with either low-dose or standard-dose weight-adjusted heparin during elective percutaneous coronary revascularization. In addition, studies have shown that patients undergoing unplanned stent deployment or ablative technologies benefit from GP IIb/IIa blockade. Patients undergoing saphenous vein graft intervention also derive specific benefits. These agent--specifically abciximab, eptifibatide (INTEGRILIN; Cor/Schering), and tirofiban--have also benefited patients with the acute coronary syndromes (e.g., unstable angina) by decreasing ischemic events.
Kereiakes
D J
DJ
The Carl and Edyth Lindner Center for Clinical Cardiovascular Research, The Christ Hospital, and The Ohio Heart Health Center, Cincinnati 45219, USA.
D000077284:Abciximab; D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D017225:Atherectomy, Coronary; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D003328:Coronary Thrombosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D016032:Randomized Controlled Trials as Topic; D015607:Stents
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077284:Abciximab