Bleeding complications with platelet glycoprotein IIb/IIIa receptor antagonists
- 1 September 1999
- journal article
- review article
- Published by Wolters Kluwer Health in Current Opinion in Hematology
- Vol. 6 (5) , 334-341
- https://doi.org/10.1097/00062752-199909000-00011
Abstract
Platelet glycoprotein (GP) IIb/IIIa receptor antagonists are being used with increasing frequency in the settings of percutaneous coronary interventions and acute ischemic syndromes. The development of bleeding complications following GPIIb/IIIa blockade represents a significant limitation to its effectiveness. Baseline characteristics predictive of future bleeding events in patients receiving platelet GPIIb/IIIa receptor antagonist include older age, low body weight, evolving myocardial infarction, and female sex. In patients undergoing percutaneous coronary interventions with adjunctive GPIIb/IIIa inhibition, the risk of bleeding, particularly from the femoral vascular access site, may be reduced through the use of low-dose, weight-adjusted heparin (70 U/kg), avoidance of postprocedural heparin, and early vascular sheath removal. Strategies to reduce the incidence of bleeding complications in patients receiving GPIIb/IIIa inhibitors are proposed in this article.Keywords
This publication has 25 references indexed in Scilit:
- Glycoprotein IIb/IIIa Integrin BlockadeCirculation, 1998
- Randomised placebo-controlled and balloon-angioplasty-controlled trial to assess safety of coronary stenting with use of platelet glycoprotein-IIb/IIIa blockadeThe Lancet, 1998
- Platelet Glycoprotein IIb/IIIa Receptor Blockade and Low-Dose Heparin during Percutaneous Coronary RevascularizationNew England Journal of Medicine, 1997
- Randomised placebo-controlled trial of abciximab before and during coronary intervention in refractory unstable angina: the CAPTURE studyThe Lancet, 1997
- Randomised placebo-controlled trial of effect of eptifibatide on complications of percutaneous coronary intervention: IMPACT-IIThe Lancet, 1997
- Use of a Monoclonal Antibody Directed against the Platelet Glycoprotein IIb/IIIa Receptor in High-Risk Coronary AngioplastyNew England Journal of Medicine, 1994
- An International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial InfarctionNew England Journal of Medicine, 1993
- Practice Strategies for Elective Red Blood Cell TransfusionAnnals of Internal Medicine, 1992
- Thrombolysis in myocardial infarction (TIMI) trial—Phase I: Hemorrhagic manifestations and changes in plasma fibrinogen and the fibrinolytic system in patients treated with recombinant tissue plasminogen activator and streptokinaseJournal of the American College of Cardiology, 1988
- Identification and preliminary validation of predictors of major bleeding in hospitalized patients starting anticoagulant therapyThe American Journal of Medicine, 1987