VALUE OF GLYCOPROTEIN LIB/ILIA RECEPTOR ANTAGONIST IN PATIENTS WITH ACUTE CORONARY SYNDROME UNDERGOING CORONARY ANGIOPLASTY

Abstract

The importance of thrombosis in the pathogenesis of acute coronary syndromes is now unequivocally established. These syndromes share a common pathophysiology of atherosclerotic plaque rupture, activation of the coagulation cascade, adhesion, activation and aggregation of platelets. In addition, interventional cardiac procedures inevitably produce damage to the endothelium and, to varying degrees, the underlying arterial wall. The exposed surfaces are highly thrombogenic and contribute to acute complications.

These facts verifies the need for more effective, yet safe, antiplatelet agents. Glycoprotein lib/Ilia, serves as the receptor on platelets that binds plasma-born adhesive proteins, such as fibrinogen, to permit platelet aggregation. Agents that block this final common pathway by blocking the binding of adhesive proteins to glycoprotein lib/Ilia, are currently considered the most powerful specific inhibitory of platelet participation in acute thrombosis.

The present study was conducted to assess the safety and efficacy of glycoprotein lib/Ilia receptor antagonist, tirofiban, in management of patients with non-ST-segment elevation acute coronary syndrome undergoing coronary angioplasty.

The study included 50 patients with non-ST-segment elevation acute coronary syndrome, who were admitted to coronary care unit and underwent coronary angioplasty during their hospital stay. All patients received on admission the conventional antiischemic therapy, but only half of them (Group A) received tirofiban. All patients were subjected to meticulous history taking, clinical examination, resting 12-lead electrocardiogram, chest X­ ray, laboratory investigation, echocardiography and coronary