Platelet glycoprotein IIb/IIIa receptor antagonists

Ivan P. Casserly, David J. Moliterno

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


The molecular understanding of platelet function, together with an appreciation of the role of platelet thrombus in the pathogenesis of acute coronary syndromes (ACS) and abrupt vessel closure following coronary intervention, lead to the development of the class of agents now referred to as platelet glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors. Currently three parenteral GP IIb/IIIa inhibitors are licensed for use in patients undergoing coronary intervention or as empirical therapy in non-ST elevation ACS (unstable angina and non-Q wave myocardial infarction). Clinical trials using these agents in patients undergoing coronary interventions have demonstrated a consistent reduction in ischaemic end points at 30 days that is sustained during long-term follow-up. Similar benefits have been found in patients with ACS who are managed medically or who proceed to revacularisation. Studies using prolonged platelet inhibition using oral GP IIb/IIIa inhibitors in patients following coronary intervention or with ACS have produced disappointing results. Further investigation with existing and newer oral agents are ongoing. The use of GP IIb/IIIa inhibitors in combination with fibrinolytic agents for optimal reperfusion in patients with acute ST-elevation myocardial infarction (MI) is an active area of interest. Angiographic outcomes with this approach have been encouraging and clinical outcome data are awaited. Beyond efficacy, GP IIb/IIIa inhibitors have proven to be safe for clinical use. Haemorrhagic complications and thrombocytopenia are the most common adverse events, though infrequent. Unresolved issues regarding drug dosing, monitoring of effect, duration of therapy, head-to-head comparisons of agents, and use of adjunctive therapies are the subject of ongoing studies. 2000

Original languageEnglish
Pages (from-to)419-433
Number of pages15
JournalExpert Opinion on Pharmacotherapy
Issue number3
StatePublished - Mar 2000


  • Acute coronary syndrome
  • Coronary intervention
  • Fibrinolysis
  • Glycoprotein IIb/IIIa antagonist
  • Platelet aggregation
  • Thrombocytopaenia

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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