Major categories of antithrombotic therapy include agents that target any one of three main components of the thrombotic process: thrombin, platelets, or fibrin.
- IIb/IIIa (tirofiban, eptifibatide, abciximab) inhibitors
- Antiplatelet agents
- Thrombin inhibitors
Glycoprotein IIb/IIIa Inhibitors are a class of antiplatelet agents that prevent platelet aggregation and thrombus formation.
Injury to the endothelium exposes receptors that promote the adhesion of platelets at the site of injury. The platelet surface is where all the chain reactions in the coagulation cascade occur. Activated platelets express 80,000 receptor sites per platelet when trying to adhere and aggregate. During platelet activation glycoprotein 2b/3a (GP Iib/IIIa) receptors are activated allowing fibrinogen molecules and Von Willebrand factor link adjacent platelets to form an aggregate. The process of aggregation takes place within 15-20 seconds of the injury, binding the platelets together that ultimately results in the formation of a thrombus (clot).
Published on Apr 7, 2015 -An overview of antiplatelet medications. Part 1 covers on aspirin. Part 2 covers P2Y12 inhibitors (e.g. clopidogrel, prasugrel, ticagrelor), IIb/IIIa inhibitors, dipyridamole, and cilostazol.
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Safety and Efficacy of Peri-Procedural Heparin Plus Short Term Infusion of Tirofiban Versus Bivalirudin in Patients Undergoing Percutaneous Coronary Intervention: Results From The Intermountain Heart Collaborative Study
Conclusion: During PCI, when comparing the efficacy of S- tirofiban versus bivalirudin, no significant differences for 30 day TIMI major bleeding or 1 year death, MI or UTVR were identified. Although trends towards reductions in both TIMI major bleeding and death were observed with the use of S-tirofiban, due to the generally low incidence of any adverse events, no statistical significance was reached.
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