Glycoprotein IIb-IIIa antagonists in non-ST elevation acute coronary syndromes and percutaneous interventions: from pharmacology to individual patient's therapy: part 1: the evidence of benefit

Monitoring and Reversal of Anticoagulation and Antiplatelets

Since percutaneous transluminal coronary angioplasty was first described and the breakthrough studies of the role of stents were reported, the evolution in anticoagulation and antiplatelet therapy used during percutaneous coronary intervention (PCI) has reduced periprocedural ischemic events and stent thrombosis. Although greater combinations and doses of anticoagulation with antiplatelets seem to provide the best protection against thrombogenic and embolic events, there is a significant trade-off with a higher risk of major and minor bleeding episodes. This review article expands on each of the commonly used antiplatelet and anticoagulants used at time of PCI, focusing on drug monitoring and reversal.

Use of glycoprotein IIb/IIIa inhibitors in unstable angina and non-ST-elevation myocardial infarction

Acute coronary syndromes (ACS) are a major cause of morbidity and mortality in Western society. The commonest underlying pathology is the coronary atherosclerotic plaque complicated by thrombosis. Platelets play a central role. As the glycoprotein IIb/IIIa receptor is involved in the final step of platelet thrombus formation development and investigation of its blockage in ACS is at the fore. Initial hospital management of ACS occur in the ED setting. The present article outlines the above topics and clarifies the place of glycoprotein IIb/IIIa receptor inhibition in ED.