Glycoprotein IIb/IIIa inhibitors during percutaneous coronary interventions

Intravenous glycoprotein IIb/IIIa inhibitors are widely used during percutaneous coronary interventions (PCIs). There are three commercially available pharmacological agents: abciximab, eptifibatide and tirofiban. This article presents the evidence indicating their use in connection with PCI, and focuses on the differences between the three regimens, as well as on their use in special clinical conditions. The documentation for their use in high-risk PCI (in other words, for acute coronary syndromes and complex coronary anatomy), and in primary PCI for ST-elevation myocardial infarction will be scrutinized, as well as the use of intracoronary administration. Furthermore, the role of glycoprotein IIb/IIIa inhibitors as opposed to, or in combination with, thienopyridines and thrombin inhibitors will be analyzed, as will their use in diabetics, in patients with renal insufficiency and when performing PCI in vein grafts. Finally, the possible effects of glycoprotein IIb/IIIa inhibitors on restenosis and inflam...