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Updated: May 5, 2026
Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
Safe use of platelet GP IIb/IIIa inhibitors
J J Ferguson1, D J Kereiakes, A A Adgey
1Texas Heart Institute, Houston 77225-0345, USA.
Insights
Abciximab, a glycoprotein IIb/IIIa receptor inhibitor, significantly reduces adverse events in high-risk coronary interventions. Safety concerns, particularly bleeding, can be mitigated with specific strategies like reduced heparin dosage and early sheath removal.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Abciximab is a widely used glycoprotein IIb/IIIa receptor inhibitor for high-risk percutaneous coronary interventions.
- It is employed in a significant portion of coronary interventions in the US and Europe.
- Clinical trials demonstrate its efficacy in reducing mortality, myocardial infarction, and revascularization needs.
Purpose of the Study:
- To review clinical progress and expert insights on the safety of abciximab.
- To formulate recommendations for enhancing the safety of potent antiplatelet agents.
- To identify future research directions for glycoprotein IIb/IIIa inhibitors.
Main Methods:
- Review of clinical trials and post-commercial release experience with abciximab.
- Insights from an international expert meeting convened in Davos, Switzerland.
- Analysis of strategies to mitigate bleeding risks associated with abciximab.
Main Results:
- Abciximab significantly reduces death, nonfatal myocardial infarction, and revascularization.
- Bleeding risk, a concern from the EPIC trial, can be substantially reduced.
- Strategies include low-dose adjunctive heparin, early sheath removal, and meticulous vascular access site care.
Conclusions:
- Enhanced safety protocols can significantly reduce bleeding complications associated with abciximab.
- These findings support the continued use of potent antiplatelet agents in appropriate clinical settings.
- Further research is warranted to optimize the use and safety of glycoprotein IIb/IIIa inhibitors.
Abstract:
The platelet membrane glycoprotein IIb/IIIa receptor inhibitor abciximab is used for the treatment of patients undergoing high-risk percutaneous coronary interventions and is used in approximately one third of coronary interventions in the United States and a growing number of procedures in Europe. Recent clinical trials have shown that this potent antiplatelet agent significantly reduces the incidence of death and nonfatal myocardial infarction and the need for revascularization. With expanding experience since the commercial release of abciximab in February 1995, several strategies to enhance the safety of abciximab have emerged. In particular, new data confirm that the risk of bleeding--identified as a concern in the original EPIC trial--can be substantially reduced through the use of low-dose adjunctive heparin, early sheath removal, and fastidious postprocedure vascular access site care. Other recommendations for enhancing the safety of potent antiplatelet agents in a variety of clinical situations are provided. The following article reflects insights regarding the safety of glycoprotein IIb/IIIa inhibitors expressed by a group of international experts convened in Davos, Switzerland, February 16, 1997. This report attempts to review clinical progress to date, formulate recommendations, and map out potentially fruitful lines of inquiry for future investigation.
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