Editorial| Volume 91, ISSUE 10, P1199-1202, May 15, 2003

The dark side of platelet glycoprotein IIb/IIIa receptor inhibitors during percutaneous coronary interventions

      Numerous placebo-controlled randomized clinical trials have demonstrated the benefit of intravenous glycoprotein (GP) IIb/IIIa inhibitors in percutaneous coronary interventions (PCIs). These agents decrease the incidence of adverse events associated with PCI in various clinical settings (ST-elevation myocardial infarction, acute coronary syndromes, and elective PCI). However, great controversy remains as to whether this benefit is confined to the prevention of small periprocedural myocardial infarctions, because a longer term clinical advantage has not been definitively shown, except with myocardial infarctions comprised of very large (>3 to 5 times normal) enzymatic increases. Nevertheless, all existing clinical trials demonstrate either a small but statistically significant benefit or a trend favoring their use. Meta-analytic methods show that although the degree of the benefit is small, when viewed in the aggregate, it appears convincing.
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