RATIONALE AND CLINICAL-EVIDENCE FOR THE USE OF GP IIB IIIA INHIBITORSIN ACUTE CORONARY SYNDROMES/

Platelet glycoprotein (GP) IIb/IIIa blockade has the potential to adva nce treatment of acute coronary syndromes, both as a primary pharmacol ogic approach and an adjunct to interventional treatment strategies. T he benefits of GP IIb/IIIa inhibition with the chimeric monoclonal ant ibody abciximab in preventing ischemic complications of interventional treatment have been well defined in patients with unstable angina. In the future, major therapeutic applications for this class of agents m ay include the stabilization of patients with unstable angina and pote ntially as single medical therapy, as several recently completed trial s have suggested. Evidence also is accumulating on the use of GP IIb/I IIa blockade as adjunctive therapy in fibrinolytic approaches to treat ment of acute myocardial infarction. Several ongoing trials are evalua ting the safety and efficacy of this novel strategy. This article refl ects a distillation of the views and consensus regarding the prospecti ve use of GP IIb/IIIa inhibitors in patients with acute coronary syndr omes expressed by a group of international experts convened in Davos, Switzerland, February 16, 1997. This report attempts to review clinica l progress to date, formulate recommendations, and map out potentially fruitful lines of inquiry for future investigation.