[Glycoprotein IIb/IIIa inhibitors in acute coronary syndromes. Which, when, how?].

The central action of platelets in pathophysiology of Acute Coronary Syndromes (ACS) has been outlined in relation to activation, inflammation and distal embolization. This platelet activation in ACS, plays the protagonistic role in the coronary artery thrombosis as the initial ischemic event, as well as in regards to its recurrence. The glycoprotein IIb/IIIa (GP IIb/IIIa) receptor is critical in this process. The introduction of this new class of drugs in the treatment of ACS has become a new tool in the initial treatment of the three main scenarios (elective intervention coronary procedures, unstable angina and acute myocardial infarction without ST elevation, and acute myocardial infarction either primary percutaneous angioplasty or in combination of low doses of thrombolytic agents) of this syndromes. This paper describes the indication and doses of the three commercially available GP IIb/IIIa inhibitors and describe the group of patients who are not candidates for this strategy.