Use of antiplatelet agents is becoming increasingly common, and their management may require new strategies if neuroaxial techniques are to be employed in patients who will not tolerate discontinuation of antiplatelet therapy. The patient was a 46-year-old man with a past medical history significant for coronary artery disease and who had undergone 14 stents. He developed stent thrombosis (ST) ...

Inhibitor Therapy To the Editor: In their clinically sound GOLD (AU-Assessing Ultegra) study, Steinhubl et al1 reported striking results concerning the widely variable level of platelet function inhibition achieved with glycoprotein IIb/IIIa (GP IIb/IIIa) antagonists among patients undergoing percutaneous coronary intervention. They also documented the important clinical implications related to...

Abstract Introduction Aspirin and a potent platelet P2Y12 inhibitor, such as prasugrel or ticagrelor, are not always sufficient to prevent thrombus formation in patients with ST-elevation MI (STEMI), leading “slow flow” “no reflow” effects after stenting. GPIIb/IIIa inhibitors, eptifibatide, may help this setting, but used routinely due their bleeding risk. GPVI has critical roles thrombosis mi...

the acute coronary syndrome due to the left main coronary artery (lmca) thrombosis is a clinically rare and catastrophic event.   we describe a young man ( smoker, alcoholic, and drug abuser) with a history of recent surgery and typical chest pain who had non-occlusive lmca thrombosis in coronary angiography. the thrombosis was successfully treated with two 180 µ/kg intracoronary boluses of ept...

Background—The relative anti-aggregatory effects of currently prescribed platelet glycoprotein IIb/IIIa receptor antagonists during and after percutaneous coronary intervention for acute coronary syndromes have not been established. Methods and Results—We randomized 70 acute coronary syndrome patients undergoing percutaneous coronary intervention to receive abciximab, eptifibatide, or tirofiban...

BACKGROUND Only limited data describe relationships between stent parameters (length and diameter), adverse events after percutaneous coronary intervention, and effects of platelet glycoprotein IIb/IIIa blockade by stent parameters. METHODS AND RESULTS In this post hoc analysis of the 1983 patients receiving a stent in the Enhanced Suppression of the Platelet Glycoprotein IIb/IIIa Receptor wi...

Background- A reactivation of ischemia after the discontinuation of intravenous heparin in acute coronary syndromes has been described. The effect of glycoprotein IIb/IIIa blockade on heparin rebound is unknown. Methods and Results- Patients with acute coronary syndromes who received heparin therapy but not initial revascularization in the Platelet IIb/IIIa in Unstable angina: Receptor Suppress...