Perspectives on the future of platelet glycoprotein IIb/IIIa blockade therapy.
During the past 2 decades, advances in molecular and cellular biology have greatly expanded our understanding of the critical role of platelets in the pathogenesis of acute coronary syndromes. This work has suggested that aggressive platelet inhibition might reduce cardiovascular morbidity and mortality rates beyond the reductions already achieved with aspirin and other conventional therapies. Researchers in basic science laboratories have identified a specific platelet receptor, the glycoprotein IIb/IIIa integrin, which serves as the mediator, or final common pathway, leading to platelet aggregation. This glycoprotein receptor is a logical target for the development of antagonists to inhibit thrombosis. A number of these antagonists have been tested in clinical trials involving coronary intervention, unstable angina, and acute myocardial infarction. Herein, I present some of the rationale behind the investigation of these agents, as well as some issues to be considered with regard to the future of this exciting new class of drugs.
Tcheng
J E
JE
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
D000077284:Abciximab; D000208:Acute Disease; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D017023:Coronary Angiography; D000077542:Eptifibatide; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D017202:Myocardial Ischemia / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010455:Peptides / Q000627:therapeutic use*; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077542:Eptifibatide; D000077284:Abciximab