Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials

Management and Outcome of Patients With Established Coronary Artery Disease: The Euro Heart Survey on Coronary Revascularization

“…diabetes) and/or procedures, 20,21 overall a sizable proportion of patients fulfiling these criteria did not receive GP IIb/IIIa receptor blockers. In addition, major variations across European hospitals in the use of GP IIb/IIIa receptor blockers were observed.…”

Acute Coronary Syndrome in the Elderly

“…14 Boersama et al concluded that GP IIb/IIIa inhibitor use resulted in a decrease in 30 day mortality or MI, but noted a declining trend in benefit with increasing age, which was also demonstrated in community observational studies primarily as a result of increased bleeding. 15 One of the reasons for increased bleeding was inappropriate dosing, especially in patients with poor renal function. It appears that GP IIb/IIIa inhibitors can be useful in the elderly, especially when dosed appropriately.…”

Early and late effects of clopidogrel in patients with acute coronary syndromes

“…The risk of bleeding with clopidogrel was similar to that observed with lowmolecular-weight heparin versus placebo (0.8% versus 0.5%) in the FRISC (Fragmin During Instability in Coronary Artery Disease) study 9 but lower than that observed in the trials of intravenous (2.4% versus 1.4%) or oral (4.1% versus 2.4%) glycoprotein IIb/IIIa inhibitors. 4,10,11 Furthermore, several of the above treatments were given for relatively short periods of time (eg, 3 days to a few weeks), and the bleeding events were mainly counted during this period. Therefore, based on these indirect comparisons, the risk-benefit balance over time with clopidogrel is at least similar (and may even be better) to that seen with other agents proven to be effective in ACS.…”