Use of glycoprotein IIb IIIa inhibition plus fibrinolysis in acute myocardial infarction

Pharmacological reperfusion therapy for acute myocardial infarction with in travenous fibrinolytic agents improves survival yet fails to achieve early and complete coronary blood flow in nearly half of treated patients. In pri nciple, glycoprotein (GP) IIb/IIIa inhibitors, potent antiplatelet agents, might improve the efficacy and clinical outcomes associated with fibrinolys is. Preclinical research suggests more rapid and effective reperfusion with combined platelet GP IIb/IIIa inhibition and fibrinolysis. Early clinical studies confirm improved early patency and more rapid electrocardiographic resolution, but increased bleeding complications, with the addition of GP I Ib/IIIa antagonists to conventional fibrinolysis. Future studies may combin e reduced-dose fibrinolytic therapy with GP IIb/IIIa inhibition to optimize efficacy and safety.