Platelet glycoprotein IIb/IIIa antagonists for acute ischemic stroke

Although thrombolytic therapy is approved in several countries for treatment of ischemic stroke, only a small number of patients are eligible for treatment. Additional agents that could restore or improve cerebral flow are needed. Reperfusion agents such as platelet glycoprotein (GP) IIb/IIIa antagonists, alone or in combination with reduced doses of thrombolytic agents, have the potential for improving safety and efficacy compared with standard recombinant tissue plasminogen activator (rt-PA). In addition, GP IIb/IIIa antagonists may permit expansion beyond the current 3-hour window after symptom onset that is used for rt-PA. On the basis of experience in acute coronary syndromes, parenteral GP IIb/IIIa antagonists may have potential applications in the treatment of acute ischemic stroke and as adjunctive therapy to carotid angioplasty.