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Glycoprotein Inhibitors and Fibrinolysis in Myocardial Infarction
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To the Editor: Drs Bhatt and Topol discussed the role of glycoprotein (Gp) IIb/IIIa inhibitors in acute coronary syndromes,1 but did not comment on the use of these agents in patients who have received fibrinolytic therapy. It is not uncommon for patients who have received such treatment to require further acute intervention. Are there any data about the risk-benefit ratio of Gp IIb/IIIa agents in patients who may subsequently require urgent angioplasty following failed fibrinolytic therapy?
Bruce L. Ring, MD
Caritas Good Samaritan Medical Practice
Stoughton, Mass
1. Bhatt DL, Topol EJ. Current role of platelet glycoprotein llb/IIIa inhibitors in acute coronary syndromes. JAMA. 2000;284:1549-1558.
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In Reply: Fibrinolysis has a proven role in the treatment of myocardial infarction (MI) with ST-segment elevation. Glycoprotein IIb/IIIa inhibition is established as an adjunct to primary percutaneous intervention (PCI) for acute MI. The Global Use of Strategies To Open Occluded Coronary Arteries (GUSTO) III trial examined the use of abciximab in patients who had ongoing ischemia following fibrinolysis with full-dose reteplase or . . . [Full Text of this Article]
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