Advances in the pharmacology of acute coronary syndrome. Platelet inhibition.
The development of potent inhibitors of platelet aggregation has led to significant decreases in morbidity and mortality rates among patients undergoing percutaneous coronary intervention. Clinical trials have demonstrated that agents that block glycoprotein IIb/IIIa receptor-mediated platelet aggregation have an outcome benefit when used acutely in patients with chest pain and ST depression or elevated cardiac enzymes, leading to the integration of these agents into emergency medicine clinical practice. This article provides an overview of the pathophysiology of acute coronary syndrome and the pharmacology of platelet inhibition and reviews the evidence from the clinical trials pertaining to the use of these agents in the emergency department.
Tiffany
B R
BR
Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona, USA.
Barrali
R
R
D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology; D003328:Coronary Thrombosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D003362:Cost-Benefit Analysis; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D004630:Emergencies; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000009:adverse effects / Q000037:antagonists & inhibitors; D013577:Syndrome
D016861:Cyclooxygenase Inhibitors; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D001241:Aspirin