Gli inibitori dei recettori glicoproteici IIB-IIIA delle piastrine nei pazienti con cardiopatia ischemica

Glycoprotein IIb-IIIa receptor inhibitors are the newest antiplatelets drugs currently used in patients with coronary artery disease. We examined mechanisms of their action and different pharmacokynetic and pharmacodynamic characteristics of the four glycoprotein IIb-IIIa antagonists evaluated in randomized, controlled and multicenter trials. We reviewed results of these trials in the settings of percutaneous revascularization procedures or unstable coronary syndromes. Platelet glycoprotein IIb-IIIa receptor inhibitors reduced incidence of cardiac death and myocardial infarction during the short- and mid-term, and benefit was greater in: a) patients undergoing coronary angioplasty with or without stent implantation, particularly in presence of unstable angina, diabetes or complex and diffuse coronary artery disease; b) as a direct therapy of unstable coronary syndromes, particularly in patients with refractory angina, diabetes and elevated Troponin; more recently they have been used as adjuvant therapy in acute myocardial infarction. Infusion of these drugs was not associated with higher rates of major bleedings.