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

Acute coronary syndromes are one of the commonest diseases requiring hospit al 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 rece ptor, which binds to circulating fibrinogen or von Willebrand factor, and c rosslinks platelets as the final common pathway of platelet aggregation. Ov er 30.000 patients have been evaluated in several, large-scale, placebo-con trolled trials using various GP IIb/IIIa antagonists during the course of a n acute coronary syndrome. The clinical benefit achieved by the administrat ion of these compounds occurred early during therapy and persisted over a p eriod of months and years. Based on these findings, the administration of G P IIb/IIIa antagonists is recommended in all patients with severe or prolon ged chest pain and particularly in patients with an elevated cardiac tropon in T or troponin I. The treatment benefit achieved with this regimen was pa rticularly apparent in those patients, in whom early coronary revasculariza tion was performed.