What are the recommendations for the use of GP IIb/IIIa inhibitors in patients with NSTE-ACS undergoing PCI?
GP IIb/IIIa receptor antagonist therapy in patients with NSTE-ACS undergoing PCI reduced the incidence of composite ischemic events, primarily through a decrease in documented MI, although in some trials this is counter-balanced by an increased rate of bleeding.193,195,310,379 382,392 Most, but not all, randomized trials of the use of GP IIb/IIIa inhibitor were conducted in the era before clopidogrel Abciximab, double-bolus eptifiba- tide, and high-bolus dose tirofiban result in a high degree of platelet inhibition, reduce ischemic complications in patients undergoing PCI, and appear to afford comparable angio- graphic and clinical outcomes.26 As trials of the GP IIb/IIIa inhibitors generally excluded patients at high risk of bleeding, recommendations for the use of GP IIb/IIIa inhibitors are best understood as applying to patients not at high risk of bleeding complications.