Glycoprotein IIb/IIIa receptor antagonists in the treatment of acute ST elevation MI: from hypotheses to unexpected recent observations.

The clinically available IIb/IIIa antagonists have been studied in small angiographic trials of patients who receive these adjuncts combined with reduced doses of fibrinolytics for the purpose of evaluating their impact on infarct artery patency restoration in acute myocardial infarction. Larger clinical endpoint trials have then looked at some of these combinations, particularly with abciximab, to characterize mortality, morbidity and adverse event frequencies when compared with more traditional full dose fibrinolytic therapy. Similarly these agents have been evaluated (without fibrinolytics) for their potential to improve the results of mechanical reperfusion techniques. This article will summarize these experiences in terms of benefits and adverse events. The value of these drugs in STEMI seems modest at best.