Glycoprotein IIb/IIIa inhibitors for heart attack and unstable angina

Examples

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Brand Name	Generic Name
ReoPro	abciximab

Brand Name	Generic Name
Integrilin	eptifibatide

Brand Name	Generic Name
Aggrastat	tirofiban

How It Works

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These medicines prevent the formation of blood clots.

Why It Is Used

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Glycoprotein IIb/IIIa inhibitors are typically used along with angioplasty, stenting, or atherectomy procedures. Glycoprotein IIb/IIIa inhibitors help prevent reclosure of the blood vessel (restenosis) after these procedures.¹ These medicines are often used along with aspirin and heparin.

How Well It Works

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After angioplasty

Glycoprotein IIb/IIIa inhibitors may reduce the chance of a heart attack when used after angioplasty with stenting and in people with unstable angina.² Although these medicines appear to be useful when given immediately after angioplasty and stenting, long-term use has not proven beneficial.

Abciximab is generally preferred over eptifibatide when angioplasty is performed. Abciximab has been shown to reduce the rate of future heart attack after angioplasty.³

Glycoprotein IIb/IIIa inhibitors may lower the risk of death in people who have angioplasty after a heart attack.⁴

Side Effects

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Some side effects of these medicines may include:

• Increased bleeding (hemorrhage) in the brain, stomach, intestines, or other internal organs.
• Increased bruising.
• Stomach irritation.
• Allergic reaction.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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If you have unstable angina and are at medium to high risk of a heart attack, you may be a candidate for glycoprotein IIb/IIIa inhibitors.⁵

Glycoprotein IIb/IIIa inhibitors are only used in the hospital, such as before or after an angioplasty.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. American College of Cardiology (ACC) and American Heart Association (AHA) (2002). Guideline update for the management of patients with unstable angina and non–ST-segment elevation myocardial infarction. Report of the ACC/AHA Task Force on Practice Guidelines. Available online: http://www.acc.org/clinical/topic/topic.htm#guidelines.

2. Lincoff AM, et al. (1999). Complementary clinical benefits of coronary artery stenting and blockage of platelet glycoprotein IIb/IIIa receptors. New England Journal of Medicine, 341(5): 319–327.

3. Brown DL, et al. (2001). Meta-analysis of effectiveness and safety of abciximab versus eptifibatide or tirofiban in percutaneous coronary intervention. American Journal of Cardiology, 87(5): 537–541.

4. De Luca G, et al. (2005). Abciximab as adjunctive therapy to reperfusion in acute ST-segment elevation myocardial infarction: A meta-analysis of randomized trials. JAMA, 293(14): 1759–1765.

5. O'Rourke RA, et al. (2001). New approaches to diagnosis and management of unstable angina and non–ST-segment elevation myocardial infarction. Archives of Internal Medicine, 161(5): 674–682.

Credits

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Author	Robin Parks, MS
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
Last Updated	May 14, 2007