[Platelet glycoprotein IIB-IIIA receptor inhibitors in patients with  ischemic heart disease].
Glycoprotein IIb-IIIa receptor inhibitors are the newest anti-platelets drugs currently used in patients with coronary artery disease. We examined mechanisms of their action and different pharmacokinetic and pharmacodynamic characteristics of the four glycoprotein IIb-IIIa antagonists evaluated in randomized, controlled and multicenter trials. We reviewed results of these trials in the settings of percutaneous revascularizations procedures or unstable coronary syndromes. Platelet glycoprotein IIb-IIIa receptor inhibitors reduced incidence of cardiac death and myocardial infarction during the short- and midterm, and benefit was greater in: a) patients undergoing coronary angioplasty with or without stent implantation, particularly in the presence of unstable angina, diabetes or complex and diffuse coronary artery disease; b) as a direct therapy of unstable coronary syndromes, particularly in patients with refractory angina, diabetes and elevated Troponin; more recently they have been used as adjuvant therapy in acute myocardial infarction. Infusion of these drugs was not associated with higher rates of major bleedings.
Patti
G
G
Dipartimento di Scienze Cardiovascolari, Università Campus Bio-Medico, Roma, Italia.
Fossati
C
C
Manzoli
A
A
D'Ambrosio
A
A
Abbate
A
A
Montesanti
R
R
Di Sciascio
G
G
D000077284:Abciximab; D000085:Acetates / Q000627:therapeutic use; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D048909:Diabetes Complications; D000077542:Eptifibatide; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D017202:Myocardial Ischemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D010455:Peptides / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors* / Q000378:metabolism*; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D016019:Survival Analysis; D013577:Syndrome; D000077466:Tirofiban; D016896:Treatment Outcome; D014336:Troponin / Q000097:blood; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000085:Acetates; D000911:Antibodies, Monoclonal; D005343:Fibrinolytic Agents; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014336:Troponin; D014443:Tyrosine; C084062:lamifiban; D000077466:Tirofiban; D000077542:Eptifibatide; D000077284:Abciximab