Fundamentals of coagulation and glycoprotein IIb/IIIa receptor inhibition

American Heart Journal
J J FergusonJ M Wilson

Abstract

An understanding of the coagulation process and the role of platelets is essential to recognizing the shortcomings of older anticoagulant therapies and appreciating the clinical potential of newer forms of antiplatelet and anticoagulant therapy for acute coronary syndromes. The anticoagulant actions of heparin are severely limited by dependence on antithrombin III, neutralization by platelet factor 4, and the resistance of clot-bound thrombin and platelet membrane-bound factor Xa to the heparin-antithrombin III complex. Unlike heparin, the direct thrombin inhibitors (such as hirudin) are active against both circulating and clot-bound thrombin. However, in recent clinical trials they have not resulted in major improvements in patient outcome. Another new class of drugs, the glycoprotein IIb/IIIa receptor antagonists, blocks the final common pathway of platelet aggregation and is capable of preventing platelet accumulation at sites of injury. The net effect is a dramatic reduction in the amount of platelet membrane available to support the process of coagulation. Clinical trials with the glycoprotein IIb/IIIa inhibitors have suggested that this class of agents may be particularly effective in reducing the thrombotic complications...Continue Reading

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Citations

Jun 18, 2002·Pharmacotherapy·Jean Nappi
Jan 16, 2007·Thrombosis Research·Qun BiShenggeng Zhu
Jul 30, 1999·American Heart Journal·J J Ferguson, K Taqi
Mar 10, 2000·Journal of Vascular Surgery·T W Wakefield
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Aug 11, 2020·Molecular Neurobiology·Nurul Sulimai, David Lominadze
May 21, 2019·Stroke and Vascular Neurology·Wei LiMeng Zhang

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