[New therapeutic prospects in acute coronary thrombosis]

The principal new clinical approaches to the treatment of acute coronary thrombosis are reviewed. They include fibrinogen platelet receptor antagonists (anti GP IIb-IIIa) and direct thrombin inhibitors. The anti GP IIb-IIIa have been shown to be effective in unstable angina and in the prevention of acute coronary occlusion after transluminal angioplasty. Thrombin inhibitors, the leader being hirudine, also give promising results. The real clinical benefits of these agents and the risk of haemorrhage that they incur in monotherapy or in association, will only become clear when the results of large scale trials which are under way at present, become available. Other antiplatelet agents (clopidogrel, thromboxane inhibitors) are also discussed.