Preferential benefit of platelet glycoprotein IIb/IIIa receptor blockade: Specific considerations by device and disease state

Several patient subgroups appear to benefit preferentially from inhibition of platelet glycoprotein (GP) IIb/IIIa receptors, In clinical trials the GP IIb/IIIa blocker abciximab (ReoPro; Lilly) proved both safe and effective in improving outcomes after coronary interventions, Endpoints of death, myocardial infarction (MI), and need for urgent intervention were significantly decreased in a randomized placebo-controlled trial of patients treated with abciximab in conjunction with either low-dose or standard-dose weight-adjusted heparin during elective percutaneous coronary revascularization. In addition, studies have shown that patients undergoing unplanned stent deployment or ablative technologies benefit from GP IIb/IIIa blockade, Patients undergoing saphenous vein graft intervention also derive specific benefits, These agents-specifically abciximab, eptifibatide (INTEGRILIN; Cor/Schering), and tiro-fiban-have also benefited patients with the acute coronary syndromes (e.g., unstable angina) by decreasing ischemic events. (C) 1998 by Excerpta Medica, Inc.