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Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease pp 267–285Cite as

Monitoring Platelet Aggregation

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

The value of inhibition of platelet function to prevent morbid events in individuals with atherosclerosis has been unequivocally established over the last two decades. The series of observations establishing efficacy began with trials of aspirin for secondary prevention (1–3), was extended to patients with cerebrovascular disease (4, 5) and acute myocardial infarction (6), and those undergoing percutaneous (7) and surgical revascularization procedures (8). Subsequently, a novel set of antiplatelet agents—the thienopyridines ticlopidine and clopidogrel—were shown to be useful in a set of similar circumstances (9, 10). Because the latter agents are more potent inhibitors of platelet aggregation, their utility, beyond that of aspirin alone, suggested that even more pro­found inhibition of platelet aggregation might prove useful in preventing arterial occlu­sion and its consequences. Consequently, the last several years have witnessed the unequivocal demonstration that intravenous antagonists of the platelet glycoprotein (GP) IIb-IIIa offer further protection against the ischemic consequences of percutaneous coronary interventions and recurrent events in patients with acute coronary syndromes (11). Further areas that are likely to be explored include patients with cerebrovascular disease and peripheral vascular disease, and those undergoing cardiopulmonary bypass. In addition, a number of orally active antagonists of platelet glycoprotein IIb-IIIa are undergoing exploration for chronic therapy.

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Authors
  1. Neal S. Kleiman MD
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  2. Wojciech Mazur MD
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  3. Nikki Graziadei BS
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Editors and Affiliations

  1. Experimental Interventional Laboratory, Joseph J. Jacobs Center for Thrombosis and Vascular Biology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

    A. Michael Lincoff MD (Associate Professor of Medicine. Director) (Associate Professor of Medicine. Director)

  2. Department of Cardiology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

    A. Michael Lincoff MD (Associate Professor of Medicine. Director) & Eric J. Topol MD (Professor of Medicine, Chairman. Director) (Associate Professor of Medicine. Director) &  (Professor of Medicine, Chairman. Director)

  3. Joseph J. Jacobs Center for Thrombosis and Vascular Biology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Eric J. Topol MD (Professor of Medicine, Chairman. Director) (Professor of Medicine, Chairman. Director)

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Kleiman, N.S., Mazur, W., Graziadei, N. (1999). Monitoring Platelet Aggregation. In: Lincoff, A.M., Topol, E.J. (eds) Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-724-6_13

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  • DOI: https://doi.org/10.1007/978-1-59259-724-6_13

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