Current Issues with Glycoprotein IIb-IIIa Antagonists

The development of glycoprotein (GP) IIb-IIIa antagonists is reviewed with particular emphasis on the characteristics of each agent, the pharmacodynamic profile of each agent, results in pivotal clinical trials, and the associated implications. GP IIb-IIIa antagonists have greatest benefit when used as adjunctive therapy during percutaneous coronary intervention (PCI) when the patient has intra-coronary thrombosis. These agents appear to provide greatest benefit when used in combination with heparin. The clinical niche for parenteral GP IIb-IIIa antagonists is evolving but appears to be for patients in transition, such as individuals requiring emergent PCI before oral agents are fully active and for unstable patients requiring transport to PCI centers. Subsequent studies should evaluate the optimal duration of therapy with GP IIb-IIIa antagonists.