[Tirofiban (Aggrastat). A non-peptide glycoprotein IIb/IIIa receptor inhibitor]

Platelet aggregation and thrombus formation on a ruptured atherosclerotic plaque plays an important role in the pathogenesis of acute coronary syndromes. Activation of glycoprotein IIb/IIIa receptors (GP-receptors) on the surface of platelets is the final common pathway which leads to the binding of fibrinogen and crosslinking of platelets to form the white thrombus. Antiplatelet therapy reduces the risk of ischaemic complications in patients with acute coronary syndromes. Recently, the GP-receptor antagonists have been introduced. They inhibit the binding of fibrinogen to the GP-receptors and thus prevent platelet aggregation. Tirofiban is a low molecular, intravenously administered GP-receptor antagonist, which in combination with unfractionated heparin in several controlled studies has been shown to decrease morbidity and mortality in patients with unstable angina pectoris and non-Q-wave infarction and, in patients subsequently undergoing percutaneous coronary intervention.