[Glycoprotein 2b3a inhibitors for acute coronary syndromes: what the trials tell us]

Glycoprotein 2b3a inhibitors represent a promising class of antiplatelet medications. Their use in acute coronary syndromes and in patients undergoing percutaneous coronary intervention has been the subject of a number of large controlled trials, including tens of thousands of patients. These trials examined their efficacy, the difference between the various agents, their influence on thrombotic events, whether it is justified to use them in patients with acute coronary syndromes, and the relationship between these medications and early versus aggressive intervention. Platelet GP 2b3a receptor inhibitors seem to have a larger effect in patients who have had a primary coronary intervention than in those with acute coronary syndromes. In patients with acute coronary syndromes, treatment should probably be limited to those considered at high risk: recurrent angina, dynamic ST segment changes, or elevated troponin values. The use of GP2b3a receptor inhibitors during angioplasty and in patients with acute coronary syndromes decreases mortality and the incidence of myocardial infarction, but increases the risk of bleeding.