[Platelet activation and inhibition. Old and new platelet antiaggregants]

Aggregates of activated platelets, at the level of a plaque fissure, seem to have a pivotal role in acute coronary syndromes. The glycoprotein IIb-IIIa receptors of the platelet surface are thought to be the final common pathway of platelet aggregation. The possibility of using a basic treatment to control platelet aggregation, in the whole clinical spectrum of acute coronary syndromes is attractive. The results of different clinical studies show evidence that glycoprotein IIb-IIIa antagonists, given intravenously, are effective in the management of acute coronary intervention with high thrombogenic risk, and also help to control the early phase of acute coronary syndromes. In patients who have responded to the acute i.v. infusion, the chronic oral administration of those agents might contribute to their clinical stabilization and reduce the risk of further coronary events.