Noncardiac applications of glycoprotein IIb/IIIa inhibitors.
Platelet activation and aggregation have become increasingly recognized as the primary processes involved in the cascade that leads to thrombus formation in atherosclerotic vascular disease. Glycoprotein IIb/IIIa receptor inhibitors (GPI) favorably impact thrombus formation and distal embolization by inhibiting the final common pathway of platelet aggregation. Glycoprotein IIb/IIIa inhibitors have been used effectively in a wide variety of clinical scenarios including unstable angina, non-ST segment elevation myocardial infarction, ST segment elevation myocardial infarction, and low and high risk percutaneous coronary interventions with and without intracoronary stenting, however there is limited data regarding the use of these potent antiplatelet agents in the setting of extracardiac vascular disease. This article will review the non-cardiac applications of glycoprotein IIb/IIIa inhibitors in the setting of acute ischemic stroke, carotid and vertebral angioplasty and stenting, acute critical limb ischemia, and percutaneous interventions in peripheral arterial occlusive disease.
Almeda
Francis Q
FQ
Section of Cardiology, Department of Medicine, Rush University Medical Center, Rush Heart Institute and Rush Medical College, Chicago, Illinois, USA. falmeda@aol.com
Schaer
Gary L
GL
D000208:Acute Disease; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy; D003131:Combined Modality Therapy; D005121:Extremities / Q000098:blood supply; D006801:Humans; D039661:Integrin beta3 / Q000378:metabolism*; D007511:Ischemia / Q000188:drug therapy; D016491:Peripheral Vascular Diseases / Q000188:drug therapy; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D040201:Platelet Membrane Glycoprotein IIb / Q000378:metabolism*; D017410:Practice Guidelines as Topic; D020521:Stroke / Q000188:drug therapy / Q000209:etiology; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D014652:Vascular Diseases / Q000097:blood / Q000188:drug therapy* / Q000209:etiology
D039661:Integrin beta3; D010975:Platelet Aggregation Inhibitors; D040201:Platelet Membrane Glycoprotein IIb