Combination therapy for acute myocardial infarction: glycoprotein IIb/IIIa inhibitors plus thrombolysis.
Although thrombolytic therapy has been a major advance in the treatment of acute ST-segment elevation myocardial infarction (MI), new thrombolytic agents have been unable to improve early reperfusion. Because aspirin has been shown to be a very effective adjunctive agent in patients with acute MI, it has been hypothesized that the use of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors combined with thrombolytic agents would lead to more effective platelet inhibition and improved angiographic and clinical efficacy. Emerging experimental and clinical data, including the Thrombolysis in Myocardial Infarction (TIMI)-14 trial, suggest that combining GP IIb/IIIa receptor inhibition with reduced-dose thrombolytic therapy improves early infarct-related artery patency without increasing bleeding risk. Thus, given the strong clinical and physiologic rationale, clinical investigation in patients with acute ST-segment elevation MI is currently focused on combining GP IIb/IIIa receptor inhibitors with reduced-dose fibrinolytic agents in acute MI.
Cannon
C P
CP
Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA.
D000789:Angina, Unstable / Q000188:drug therapy; D001241:Aspirin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010976:Platelet Count; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D016019:Survival Analysis; D015912:Thrombolytic Therapy / Q000009:adverse effects
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D001241:Aspirin