© 2003 by BMJ Publishing Group & British Cardiac Society
EDITORIAL
Who would I not give IIb/IIIa inhibitors to during percutaneous coronary intervention?
Correspondence to:
Correspondence to:
Dr James M McLenachan, Department of Cardiology, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK;
carole.noble@leedsth.nhs.uk
Glycoprotein IIb/IIIa inhibitors should make the procedure of percutaneous coronary intervention safer for the patient. So should these agents be administered to every patient undergoing PCI?
Keywords: glycoprotein IIb/IIIa inhibitors; percutaneous coronary intervention
| The first 150 words of the full text of this article appear below. |
Coronary artery stenting and platelet IIb/IIIa receptor antagonists confer complementary benefits on patients undergoing percutaneous coronary intervention (PCI). Glycoprotein (Gp) IIb/IIIa inhibitors make the procedure safer by reducing periprocedural complications such as myocardial infarction, while stenting reduces restenosis rates and the need for further revascularisation procedures.
If Gp IIb/IIIa inhibitors make PCI safer, then should every PCI patient receive a Gp IIb/IIIa inhibitor? It is difficult to argue against this. Studies of Gp IIb/IIIa inhibitors with mandatory PCI have almost invariably shown benefit from active treatment; within these studies, multiple subgroup analyses have generally shown increased benefit in specific subgroups, particularly among diabetics patients and those with raised troponin concentrations. No subgroup analysis, however, has identified a group of patients that is harmed by adjunctive Gp IIb/IIIa inhibitor treatment during PCI.
The simplistic answer, therefore, to the question as to who should and who should not receive Gp IIb/IIIa inhibitors
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