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Platelet glycoprotein IIb/IIIa antagonists: perioperative implications.

THE COST OF RESTENOSIS after percutaneous coronary interventions and revascularization procedures is estimated to exceed $2 billion annually.1 Consequently, there is great interest in the development of adjuvant anticoagulant drugs and antiplatelet agents. Platelet glycoprotein (GP) IIb/IIIa receptor antagonists have shown great promise as adjunctive therapy in patients undergoing percutaneous coronary interventions. To date, more than 40,000 patients with ischemic heart disease have been treated with platelet GP IIb/IIIa antagonists.2 Some of these patients subsequently required urgent coronary artery bypass graft (CABG) surgery with substantial risks for adverse outcomes related to impaired hemostasis. Understanding the mechanisms of action, drug interactions, and adverse side effects of these novel platelet antagonists can lead to strategies to decrease the potential for adverse perioperative outcomes after the administration of GP IIb/IIIa antagonists.