2001, Number S1
<< Back Next >>
Arch Cardiol Mex 2001; 71 (S1)
IIb/IIIa inhibitors in acute coronary syndromes. which, when, how?
Juárez HÚ
Language: Spanish
References: 8
Page: 85-90
PDF size: 53.71 Kb.
ABSTRACT
The central action of platelets in pathophysiology of Acute Coronary Syndromes (ACS) has been outlined in relation to activation, inflammation and distal embolization. This platelet activation in ACS, plays the protagonic role in the coronary artery thrombosis as the initial ischemic event, as well as in regards to its recurrence. The glycoprotein IIb/IIIa (GP IIb/IIIa) receptor is critical in this process. The introduction of this new class of drugs in the treatment of ACS has become a new tool in the initial treatment of the three main scenarios (elective intervention coronary procedures, unstable angina and acute myocardial infarction without ST elevation, and acute myocardial infarction either primary percutaneous angioplasty or in combination of low doses of thrombolytic agents) of this syndromes. This paper describes the indication and doses of the three commercially available GP IIb/IIIa inhibitors and describe the group of patients who are not candidates for this strategy.
REFERENCES
JUÁREZ HERRERA U, LÓPEZ RM, GONZÁLEZ PH, MARTÍNEZ SC, LASSES Y OJEDA LA, CHUQUIURE VE, ET AL: Nueva terapia antitrombótica en el tratamiento de pacientes con angor inestable. Arch Inst Cardiol Méx 1998; 68: 157-165.
LEVKOVITS J, TOPOL EJ: Platelet glycoprotein IIb/IIIa receptor inhibitors in ischemic herat disease. Cur Opin Cardiol 1995; 10: 420-426.
AULT KA, CANNON CP, MITCHELL J: Platelet activation in patients after an acute coronary syndrome: results from the TIMI-12 trial. J Am Coll Cardiol 1999; 33: 634-639.
LINCOFF M, CALIFF R, MOLITERNO D, ELLIS S, DUCAS J, KRAMER J, ET AL: Complementary clinical benefits of coronary-artery stenting and blockade of platelet glycoprotein IIb/IIIa receptors. N Engl J Med 1999; 341: 319-327.
SABATINE M, KYUNG JI: The use of glycoprotein IIb/IIIa inhibitors in patients with coronary artery disease. Am J Med 2000; 109: 224-237.
HEESCHEN C, HAM CW, GOLDMANN B, ARIENE D, LANGENBRINK L, WHITE HD: Troponin concentrations for stratification of patients with acute coronary syndromes in relation to therapeutic efficacy of tirofiban. Lancet 1999; 354: 1757-1762.
BERTRAND ME, SIMOONS ML, FOX KAA, WALLENTIN LC, HAMM CW, MCFADEN E, ET AL: Management of acute coronary Syndromes: acute coronary syndromes without persistent ST elevation. Recommendations of the Task Force of the European Society of Cardiology. Eur Heart J 2000; 17: 1406-1432.
BHATT DL, TOPOL EJ: Current role of platelet glycoproyein IIb/IIIa inhibitors in acute coronary syndromes. JAMA 2000; 284: 1549-1558.