PLATELET GLYCOPROTEIN IIB IIIA RECEPTOR INHIBITORS IN ISCHEMIC-HEART-DISEASE/

The key role of platelets in the pathogenesis of ischemic heart diseas e has led to the development of new classes of agents to control plate let function. The platelet glycoprotein IIb/IIIa receptor mediates the final common pathway to platelet aggregation. Drugs that block the gl ycoprotein IIb/IIIa receptor potently inhibit platelet aggregation. Mo noclonal antibodies, cyclic peptides, and peptide-derivative glycoprot ein IIb/IIIa inhibitors have been developed. The monoclonal antibody F ab fragment, chimeric 7E3, has been shown to significantly reduce isch emic complications and clinical restenosis after high-risk angioplasty in the large-scale Evaluation of 7E3 for the Prevention of Ischemic C omplications (EPIC) trial. A number of glycoprotein IIb/IIIa inhibitor s have been tested in patients with unstable angina with similarly pos itive results, and initial trials in patients with acute myocardial in farction are also encouraging. Further evaluation of these agents in l arge scale trials is currently underway and should help determine the place and appropriate use of these agents in the clinical arena.