Clinical benefit of glycoprotein IIb/IIIa receptor antagonists in patients with acute coronary syndrome

Acute coronary syndromes are one of the commonest diseases requiring hospital admission in Western countries with an estimated incidence of 2 per 1000 admissions annually. New strategies for the inhibition of platelets focus on the blockade of the platelet surface membrane glycoprotein IIb/IIIa receptor, which binds to circulating fibrinogen or von Willebrand factor, and crosslinks platelets as the final common pathway of platelet aggregation. Over 30.000 patients have been evaluated in several, large-scale, placebo-controlled trials using various GP IIb/IIIa antagonists during the course of an acute coronary syndrome. The clinical benefit achieved by the administration of these compounds occurred early during therapy and persisted over a period of months and years. Based on these findings, the administration of GP IIb/IIIa antagonists is recommended in all patients with severe or prolonged chest pain and particularly in patients with an elevated cardiac troponin T or troponin I. The treatment benefit achieved with this regimen was particularly apparent in those patients, in whom early coronary revascularization was performed.