Platelet glycoprotein IIb/IIIa inhibitors for acute coronary syndromes: initiate treatment early or wait for the catheterization laboratory?
Treatment of patients with acute coronary syndromes (ACS) incorporates several approaches to reverse or mitigate the thrombus, which invariably is at the center of the pathophysiologic process of ACS. Pharmacologic and mechanical strategies are designed to prevent death, reduce myocardial necrosis, and stabilize the plaque to prevent later sequelae. Conventional antithrombotic therapy includes antiplatelet and anticoagulant drugs. Medications that inhibit the platelet glycoprotein IIb/IIIa receptor have been shown to be especially efficacious in the treatment of ACS. Recent clinical trials have validated a strategy of aggressive revascularization, particularly catheter-based percutaneous procedures. This review summarizes new trial results and provides a working algorithm for care of the patient with ACS.
Harnick
D J
DJ
The Zena and Michael A. Weiner Cardiovascular Institute, Mount Sinai Medical Center, 1 Gustave L. Levy Place, Box 1030, New York, NY 10029, USA. david.vorchheimer@msnyuhealth.org
Vorchheimer
D A
DA
D000789:Angina, Unstable / Q000188:drug therapy*; D015906:Angioplasty, Balloon, Coronary; D002986:Clinical Trials as Topic; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*
D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex