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/IIa receptors. In clinical trials the GP IIb/IIa 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/IIa blockade. Patients undergoing saphenous vein graft intervention also derive specific benefits. These agent--specifically abciximab, eptifibatide (INTEGRILIN; Cor/Schering), and tirofiban--have also benefited patients with the acute coronary syndromes (e.g., unstable angina) by decreasing ischemic events.

RCT Entities:   Population Interventions Outcomes