Anti-thrombotic and anticoagulant treatment in interventional cardiology

Efforts to improve Percutaneous Transluminal Coronary Angioplasty (PTCA) have resulted in the usage of new antiplatelets, and antithrombotic agents. These new agents may increase bleeding complications. However, EPIC, EPILOG and CAPTURE trials showed benefits of 7E3, a GPIIb/IIIa platelets receptor blocker, in high risk PTCA patients. On the other hand, direct thrombin inhibitors, Hirudin and Hirulog, did not clearly show any benefit when compared to heparin in patients with unstable angina undergoing PTCA. Combination of oral antiplatelets, ticlopidine and aspirin, is widely utilized following stent implantation. However, its benefit over aspirin alone has not been demonstrated. This article aims to review mechanisms and benefits of these new agents in cardiovascular field.