Antiplatelet Therapy in AMI: Combining GP IIb/IIIa Inhibition with Reduced-dose Fibrinolytic Therapy.
In the therapy of ST-segment elevation myocardial infarction (MI), the close relationship between early reperfusion of the infarct-related artery and improved outcomes has focused research on improving the speed and efficacy of pharmacologic reperfusion therapy. Recently, it has become appreciated that even among patients who achieve normal epicardial reperfusion after reperfusion therapy, myocardial and microvascular perfusion may be inadequate. Such patients are at increased risk for the development of death and congestive heart failure. The addition of glycoprotein (GP) IIb/IIIa antagonists to standard fibrinolytic therapy has been shown to improve both epicardial and myocardial reperfusion. This article focuses on emerging data regarding the combination of GP IIb/IIa antagonists and standard fibrinolytic agents for the treatment of acute ST-segment elevation MI.
Watkins
Stanley P.
SP
University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, H8.116, Dallas, TX 75390, USA. james.delemos@utsouthwestern.edu
de Lemos
James A.
JA