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Platelet glycoprotein receptor site blockade in coronary artery disease

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Abstract

The advent of platelet glycoprotein IIb/IIIa receptor blockade has been one of the most significant advances in the treatment of coronary artery disease. This group of drugs has been widely tested both in patients with acute coronary syndromes who are being medically treated, as well as patients undergoing interventional procedures. Debate as to the optimal use if these agents remains spirited. This debate rests on several factors, including 1) economic issues, as these drugs are expensive, 2) controversy over the meaning of specific endpoints, eg, in an otherwise uncomplicated coronary intervention, the meaning of creatine phosphokinase elevation post-procedure, and 3) what is the risk benefit ratio given the costs involved and the potential risks? Several questions remain. Do all patients with acute coronary syndromes need this as a part of medical therapy? Do all patients undergoing percutaneous coronary interventions need this group of agents, or are there populations of patients who do not need them? Are there differences between the agents that are clinically important? Is there a specific device-drug interaction? Continued evaluation of these questions will facilitate improving the outcome of the diverse group of patients treated for coronary artery diseases.

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References and Recommended Reading

  1. Vorchheimer DA, Badimon JJ, Fuster V: Platelet glycoprotein IIb/IIIa receptor antagonists in cardiovascular disease. JAMA 1999, 281:1407–1414.

    Article  PubMed  CAS  Google Scholar 

  2. Dobesh PP, Latha KA: Advancing the battle against acut ischemic syndromes: a focus on the GPIIb/IIIa inhibitors. Pharmacotherapy 1998, 18(4):663–685.

    PubMed  CAS  Google Scholar 

  3. Lefkovits J, Topol EJ: Platelet inhibitor agents in ischemic heart disease. In Textbook of Cardiovascular Medicine Updates, vol 1, no 6. Edited by Topol EJ. Philadelphia; Lippincott-Raven: 1998.

    Google Scholar 

  4. Lefkovits J, Plow EF, Topol EJ: Platelet glycoprotein IIb/IIIa receptors in cardiovascular medicine. N Engl J Med 1995, 332 1553–1559.

    Article  PubMed  CAS  Google Scholar 

  5. Schwartz L, Seidelin PH: Antithrombotic and thrombolytic therapy in patients undergoing coronary artery interventions: a review. Prog Cardiovasc Dis 1995, 38:67–86.

    Article  PubMed  CAS  Google Scholar 

  6. Topol EJ, Byzova TV, Plow EF: Platelet GPIIb-IIIa blockers. Lancet 1999, 353:227–231.

    Article  PubMed  CAS  Google Scholar 

  7. Ellis SG, Serruys PW, Popma JJ, et al.: Can abciximab prevent neointimal proliferation in Palmaz-Schatz stents? The final ERASER results. Circulation 1997, 96S:87.

    Google Scholar 

  8. The EPIC Investigators: Use of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angioplasty. N Engl J Med 1994, 330:956–961.

    Article  Google Scholar 

  9. The EPILOG Investigators: Platelet glycoprotein IIb/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularization. N Engl J Med 1997, 336:1689–1696.

    Article  Google Scholar 

  10. Ellis SG, Lincoff AM, Miller D, et al.: Reduction in complications of angioplasty with abciximab occurs largely independently of baseline lesion morphology. J Am Coll Cardiol 1998, 32:1619–1623.

    Article  PubMed  CAS  Google Scholar 

  11. The EPISTENT Investigators: Randomized placebo controlled and balloon angioplasty controlled trial to assess safety of coronary stenting with use of platelet glycoprotein IIb/IIIa blockade Lancet 1998, 352:87–92.

    Article  Google Scholar 

  12. Brener SJ, Barr LA, Burchenal, et al.: for the ReoPro and Primary PTCA Organization and Randomized Trial (RAPPORT) Investigators: Randomized, placebo-controlled trial of platelet glycoprotein IIb/IIIa blockade with primary angioplasty for acute myocardial infarction. Circulation 1998, 98:734–741.

    PubMed  CAS  Google Scholar 

  13. The CAPTURE Investigators: Randomised placebo-controlled trial of abciximab before and during coronary intervention in refractory unstable angina: the CAPTURE study. Lancet 1997, 349:1429–1435.

    Article  Google Scholar 

  14. Hamm, CW, Heeschen C, Goldmann B, et al.: Benefit of abciximab in patients with refractory unstable angina in relation to serum troponin T levels. N Engl J Med 1999, 340:1623–1629.

    Article  PubMed  CAS  Google Scholar 

  15. The RESTORE Investigators: Effects of platelet glycoprotein IIb/ IIIa blockade with tirofiban on adverse cardiac events in patients with unstable angina or acute myocardial infarction undergoing coronary angioplasty. Circulation 1997, 96:1445–1453.

    Google Scholar 

  16. The IMPACT-II Investigators: Randomised placebo-controlled trial of Eptifibatide on complications of percutaneous coronary intervention: IMPACT-II. Lancet 1997, 349:1422–1428.

    Article  Google Scholar 

  17. McClure MW, Berkowitz SD, Sparapani R, et al.: Clinical significance of thrombocytopenia during a non-ST-elevation acute coronary syndrome. Circulation 1999, 99 2892–2900.

    PubMed  CAS  Google Scholar 

  18. The PURSUIT Trial Investigators: Inhibition of the platelet glycoprotein IIb/IIIa with Eptifibatide in patients with acute coronary syndromes. N Engl J Med 1998, 338:1488–1497.

    Article  Google Scholar 

  19. Lincoff AM, Califf RM, Anderson KM, et al.: Evidence for prevention of death and myocardial infarction with platelet membrane glycoprotein IIb/IIIa receptor blockade by abciximab (c7E3 Fab) among patients with unstable angina undergoing percutaneous coronary revascularization. J Am Coll Cardiol 1997, 30:149–156.

    Article  PubMed  CAS  Google Scholar 

  20. Topol EJ, Ferguson JJ, Weisman HF, et al.: Long-term protection from myocardial ischemic events in a randomized trial of brief integrin b3 blockade with percutaneous coronary intervention. JAMA 1997, 278 479–484.

    Article  PubMed  CAS  Google Scholar 

  21. The PARAGON Investigators: International, randomized, controlled trial of lamifiban (a platelet glycoprotein IIb/IIIa inhibitor), heparin, or both in unstable angina. Circulation 1998, 97 2386–2395.

    Google Scholar 

  22. The PARADIGM Investigators: Combining thrombolysis with the platelet glycoprotein IIb/IIIa inhibitor lamifiban: results of the Platelet Aggregation Receptor Antagonist Dos Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) trial. J Am Coll Cardiol 1998, 32:2033–2010.

    Google Scholar 

  23. The PRISM-Plus Study Investigators: International, randomized, controlled trial of lamifiban (a platelet glycoprotein IIb/IIIa inhibitor), heparin, or both in unstabl angina. Circulation 1998, 338 1488–1497.

    Google Scholar 

  24. The PRISM Study Investigators: A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina. N Engl J Med 1998, 338:1498–1505.

    Article  Google Scholar 

  25. The PURSUIT Trial Investigators: Inhibition of the platelet glycoprotein IIb/IIIa with Eptifibatide in patients with acute coronary syndromes. N Engl J Med 1998, 339:436–443.

    Article  Google Scholar 

  26. Aguirre FV, Topol EJ, Ferguson JJ, et al.: Bleeding complications with the chimeric antibody to platelet glycoprotein IIb/IIIa integrin in patients undergoing percutaneous coronary intervention. Circulation 1995, 91:2882–2890.

    PubMed  CAS  Google Scholar 

  27. Berkowitz SD, Harrington RA, Rund MM, et al.: Acute profound thrombocytopenia after c7E3 Fab (abciximab) therapy. Circulation 1997, 96:3810.

    Google Scholar 

  28. Ohman EM, Kleiman NA, Gacioch G, et al.: Combined accelerated tissue-plasminogen activator and platelet glycoprotein IIb/IIIa integrin receptor blockade with Integrilin in acute myocardial infarction: results of a randomized, placebocontrolled, dose-ranging trial. Circulation 1997, 96S:87.

    Google Scholar 

  29. Ohman EM, Kleiman NA, Gacioch G, et al.: for the IMPACTAMI Investigators: Combined accelerated tissue-plasminogen activator and platelet glycoprotein IIb/IIIa integrin receptor blockade with Integrilin in acute myocardial infarction: results of a randomized, placebo-controlled, dose-ranging trial. Circulation 1998, 98S:360.

    Google Scholar 

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Authors and Affiliations

  1. Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA

    David R. Holmes Jr. MD, FACC

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  1. David R. Holmes Jr. MD, FACC
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Holmes, D.R. Platelet glycoprotein receptor site blockade in coronary artery disease. Curr Cardiol Rep 2, 69–73 (2000). https://doi.org/10.1007/s11886-000-0028-z

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  • DOI: https://doi.org/10.1007/s11886-000-0028-z

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