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[Current approach in antithrombotic treatment during coronary interventions: specific thrombocyte aggregation
1Departement Innere Medizin, Inselspital Bern.
Insights
New anti-thrombotic drugs, including GP IIb/IIIa antagonists and thrombin inhibitors, significantly reduce thrombotic events in high-risk angioplasty patients. These agents offer improved safety compared to traditional heparin therapy.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Interventional Cardiology
Abstract:
Patients undergoing angioplasty (PTCA) for unstable angina, postinfarction angina, or complex coronary lesions represent a high risk group for ischemic complications. High dose heparin and aspirin are used routinely to prevent thrombotic complications. However, new approaches designed to avoid platelet aggregation, including development of specific platelet GP IIb/IIIa receptor antagonists and specific thrombin inhibitors, demonstrate a significant reduction of thrombotic events following coronary interventions compared to heparin alone. Bleeding complications are not increased if conjunctive heparin administration is weight-adjusted. Pathophysiology of acute coronary closure, mechanisms of action of the new anti-thrombotic drugs, and current and future clinical applications are discussed.