What is the role of glycoprotein (GP) IIb/IIIa receptor inhibitors in the treatment of non-ST-elevation acute coronary syndrome (unstable angina and NSTEMI), and which agents are preferred?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

The Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial [102] and the Randomized Efficacy Study of Tirofiban for Outcomes and Restenosis (RESTORE) trial [103] demonstrated the efficacy of these agents in the treatment of NSTE-ACS.

The preferred GP IIb/IIIa receptor inhibitors are eptifibatide or tirofiban. Patients undergoing an early invasive strategy who received dual antiplatelet therapy with high-risk features are considered candidates to receive either of these two agents. [1, 3]

However, GP IIb/IIIa agents are associated with an increased risk of bleeding complications, and most of the clinical trials studying these drugs were completed prior to the release of the P2Y12 receptor inhibitors. Thus, their use in NSTE-ACS is limited currently.


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