Antithrombotics and interventional cardiology.

Angioplasty is a technique associated until recently with aspirin and heparin therapy, two classical molecules, for the prevention of thrombotic complications. The first therapeutic innovation has been the introduction of Reopro (abciximab, c7E3). The abciximab has been shown to be useful in the short term, sometimes in the medium (EPIC, EPILOG) and long term (EPIC) in all acute or stable coronary coronary syndromes requiring angioplasty with or without stenting. Other changes are awaited shortly with the arrival of low molecular weight heparin which some have shown to be effective in unstable angina. The association of antithrombotics will become the rule but the number of molecules should decrease to consist only of the most effective drugs and exclude the redundant ones. The risk of haemorrhage increases with the increased efficacy of the antithrombotic agent. Global evaluation of the clinical benefits should be advocated with a register of ischaemic and serious haemorrhagic events amongst the criteria of evaluation of the trials.