Glycoprotein IIb/IIIa receptors and primary stenting in acute myocardial infarction

The past 15 years have seen great progress in the treatment of acute myocardial infarction (MI), with the development of thrombolytic agents and catheter-based reperfusion strategies such as percutaneous transluminal coronary angioplasty (PTCA). Because both thrombolytics and PTCA have limitations in achieving large-vessel patency, stenting has been adopted as the treatment modality of choice for planned elective revascularization. In addition, an increasing number of studies have indicated that the class of antiplatelet drugs known as glycoprotein (GP) IIb/IIIa receptor inhibitors can reduce ischaemic events following both elective and acute percutaneous coronary interventions. The results have been unequivocally positive regarding the benefits of these agents in PTCA procedures, but less information is available on their use with primary stenting in acute MI. This article reviews the rationale and emerging evidence supporting the use of GP IIb/IIIa receptor inhibitors in conjunction with primary stenting for acute MI