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Direct Thrombin Inhibitors for Percutaneous Coronary Intervention in the Current Era of Platelet Glycoprotein IIb/IIIa Inhibition

Direct Thrombin Inhibitors for Percutaneous Coronary Intervention in the Current Era of Platelet... Introduction Since the advent of percutaneous coronary intervention (PCI) over two decades ago, the field of interventional cardiology has been marked by a rapid evolution in technique, device technology, and pharmacologic therapy. The last 10 years alone have been witness to the introduction and widespread use of intracoronary stents, intravenous platelet glycoprotein (GP) IIbAIIa receptor antagonists (GP IIbAIIa inhibitors), and oral thienopyridine platelet adenosine diphosphate (ADP)receptor antagonists. In contrast to these sweeping advances, anticoagulation has remained essentially unchanged; unfractionated heparin has reigned supreme as the antithrombotic-of-choice in PCI. It is understandable that unfractionated heparin has not been supplanted when one considers the wealth of clinical experience with the drug and its relatively low cost. However, there are important shortcomings to heparin that have fueled research efforts to develop novel antithrombotic therapies. Data from recently completed and ongoing clinical trials suggest that a relatively new class of drugs, known as direct thrombin inhibitors, may be poised to supersede unfractionated heparin in PCI. Should this prove to be the case, the next challenge will lie in determining the optimal manner in which to dose and monitor these new agents in conjunction with existing pharmacologic therapies of proven benefit in PCI, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Direct Thrombin Inhibitors for Percutaneous Coronary Intervention in the Current Era of Platelet Glycoprotein IIb/IIIa Inhibition

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References (38)

Publisher
Wiley
Copyright
Copyright © 2002 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/j.1540-8183.2002.tb01046.x
Publisher site
See Article on Publisher Site

Abstract

Introduction Since the advent of percutaneous coronary intervention (PCI) over two decades ago, the field of interventional cardiology has been marked by a rapid evolution in technique, device technology, and pharmacologic therapy. The last 10 years alone have been witness to the introduction and widespread use of intracoronary stents, intravenous platelet glycoprotein (GP) IIbAIIa receptor antagonists (GP IIbAIIa inhibitors), and oral thienopyridine platelet adenosine diphosphate (ADP)receptor antagonists. In contrast to these sweeping advances, anticoagulation has remained essentially unchanged; unfractionated heparin has reigned supreme as the antithrombotic-of-choice in PCI. It is understandable that unfractionated heparin has not been supplanted when one considers the wealth of clinical experience with the drug and its relatively low cost. However, there are important shortcomings to heparin that have fueled research efforts to develop novel antithrombotic therapies. Data from recently completed and ongoing clinical trials suggest that a relatively new class of drugs, known as direct thrombin inhibitors, may be poised to supersede unfractionated heparin in PCI. Should this prove to be the case, the next challenge will lie in determining the optimal manner in which to dose and monitor these new agents in conjunction with existing pharmacologic therapies of proven benefit in PCI,

Journal

Journal of Interventional Cardiology – Wiley

Published: Apr 1, 2002

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