title: GP IIb/IIIa inhibitors for STEMI: still the gold standard or an old survivor?
abstract: Glycoprotein (GP) IIb\IIIa receptor plays a central role on platelets activation and its blockage has been a matter of interest since the beginning of percutaneous revascularization. After first promising trials, GP IIb\IIIa inhibitors (GPI) have been widely used in cath labs for about a decade, significantly improving prognosis for patients with STSegment Elevation Myocardial Infarction (STEMI). However, their utilization isn't exempt from risks, mainly in form of bleeding disorders, which can negatively affect patients' outcome. Moreover, routinary administration of thyenopiridines like clopidogrel and the introduction of new anticoagulants like bivalirudin significantly reduced indications for GPI. In this review, a risk/benefit evaluation GP IIb\IIIa inhibitors is presented and their indications for STEMI patients addressed to revascularization are discussed according to recent advances reported in literature.
authors.affiliation: Cardiovascular Department, Ospedali Riuniti di Bergamo, Largo Barozzi 1, Bergamo, Italy. giuseppe.musumeci@gmail.com
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
authors.forename: Matteo
authors.initials: M
authors.lastname: Baroni
authors.forename: Roberta
authors.initials: R
authors.lastname: Rossini
mesh_terms: D000077284:Abciximab; D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D000077542:Eptifibatide; D019317:Evidence-Based Medicine; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007275:Injections, Intravenous; D009203:Myocardial Infarction / Q000188:drug therapy*; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D000077466:Tirofiban; D014443:Tyrosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D000077466:Tirofiban; D000077542:Eptifibatide; D000077284:Abciximab