Abstract
The increasing interest in acute coronary syndromes (ACS) (unstable angina, non-Q wave infarction) has been accompanied by a number of studies aimed at improving clinical outcome in these patients. The beneficial effect of aspirin and heparin in ACS is clear, as is the benefit of revasculalization in high risk patients. The favorable results of trials involving platelet glycoprotein IIb/IIIa receptor antagonists - EPIC and CAPTURE (abciximab), PURSUIT (eptifibatide), PRTSM-PLUS and RESTORE (tirsfiban) highlight the crucial role of the platelet in the pathogenesis of ACS, particularly in patients undergoing percutaneous intervention. Anti-platelet therapy is being further investigated in the GUSTO-4 (abciximab) and OASIS-4 (clopidogrel) studies. The importance of ongoing thrombosis may be implied from the positive results of new direct and indirect antithrombins in the OASIS-2 (hirudin) and ESSENCE and TIMI 11B (enoxaparin) studies. The negative result of thrombolytic trials in ACS implies a lesser role for established thrombus and fibrin mass as a major pathogenetic mechanism. Newer therapeutic strategies have improved clinical outcome in ACS with a compelling decrease in the acute event rate (death, infarction, refractory angina).
| Original language | English |
|---|---|
| Title of host publication | CARDIOVASCULAR PHARMACOTHERAPY |
| Subtitle of host publication | proceedings of the 9th International congress on cardiovascular pharmacotherapy : Salvador, Bahia, Brazil, March 26-30, 2000 |
| Editors | Ariel J. Reyes, Mário F. C. Maranhão |
| Pages | 27-32 |
| Number of pages | 6 |
| State | Published - 2000 |
Keywords
- ACUTE MYOCARDIAL-INFARCTION
- UNSTABLE ANGINA
- TROPONIN-T
- ASPIRIN
- DEATH
- THROMBOLYSIS
- HEPARIN
- DISEASE