Humana Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease (Contemporary Cardiology)

One of the most important developments in the field of cardiovascular medicine over the last two decades has been recognition of the key role played by arterial thrombosis in the pathogenesis of acute coronary syndromes, ischemic complications of percutane ous coronary revascularization, and coronary and peripheral atherosclerosis. The phar macologic armamentarium directed against vascular thrombosis has thus expanded substantially during that time, with development of new fibrinolytic agents, low-molecu lar-weight heparins, direct thrombin inhibitors, antagonists to platelet activation, and the platelet glycoprotein lIb/IlIa inhibitors. Though clinical investigations of these com pounds have been marked by failures as well as successes, there is little doubt that enhanced antithrombotic therapies have markedly improved the outcome of patients undergoing coronary revascularization or with acute coronary syndromes. Glycoprotein IIblIlIa receptor antagonists were introduced into clinical practice to overcome the limitations of approaches that inhibit only individual pathways of platelet activation. Multiple mechanisms of platelet activation in response to different agonists converge on the platelet membrane glycoprotein IIblIlIa complex, the "final common pathway" of platelet aggregation. The clinical hemorrhagic syndrome caused by a rare inherited defect in this receptor (Glanzmann' s thrombasthenia), characterized by muco cutaneous and postsurgical bleeding, but infrequent spontaneous organ (particularly central nervous system) bleeding, suggested that therapeutic inhibition of this receptor might be a potent, yet well-tolerated means of treating thrombotic disorders. Review "...provides the reader with extensive and profound information about this new class, based on data from completed and ongoing trials...can be recommended not only to cardiologists but to all clinicians and researchers interested in this field." -Intensive Care Medicine From the Back Cover A. Michael Lincoff takes advantage of critically important new knowledge arising from recent clinical trials to update and expand his acclaimed Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease. This substantially enhanced Second Edition contains new chapters on the role of GPIIb/IIIa blockade during acute coronary syndromes, on outcomes with chronic oral GPIIb/IIIa blockade following acute coronary syndromes, and on fibrinolytic therapy during acute myocardial infarctions. Additional enhancements include revised findings from the latest trials of GPIIb/IIIa inhibition during percutaneous coronary intervention, discussion of GPIIb/IIIa blockade with other platelet and thrombin inhibitors, and a review of the potential effects beyond inhibition of platelet aggregation. The book also explains the scientific basis of this therapy, evaluates its benefits and risks for patients, and summarizes detailed data from its various clinical trials. Comprehensive and definitive, Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease, Second Edition offers physicians, cardiologists, emergency room doctors, and basic scientists a complete and authoritative review of the state-of-the-art in glycoprotein IIb/IIIa receptor inhibitor use today.