Antiplatelet, antithrombotic, and lytic therapy for unstable angina, and the appropriate role of revascularization

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Abstract
The management of unstable angina continues to be a challenge for the clinician. Evidence is accumulating that inflammation plays an important role in plaque rupture and thrombosis. Thrombolytic treatment is not indicated in unstable angina, and in fact may even be harmful. The use of new platelet glycoprotein IIb/IIIa receptor antagonists and direct thrombin inhibitors offers great potential in the management of unstable angina. Balloon angioplasty for unstable angina is associated with a high major complication rate, which can be reduced by the use of these novel agents. New techniques such as directional atherectomy do not appear to be safer than balloon angioplasty.

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