Lefkovits J, Topol E J
Department of Cardiology, Cleveland Clinic Foundation, OH 44195, USA.
Curr Opin Cardiol. 1995 Jul;10(4):420-6. doi: 10.1097/00001573-199507000-00012.
The key role of platelets in the pathogenesis of ischemic heart disease has led to the development of new classes of agents to control platelet function. The platelet glycoprotein IIb/IIIa receptor mediates the final common pathway to platelet aggregation. Drugs that block the glycoprotein IIb/IIIa receptor potently inhibit platelet aggregation. Monoclonal antibodies, cyclic peptides, and peptide-derivative glycoprotein IIb/IIIa inhibitors have been developed. The monoclonal antibody Fab fragment, chimeric 7E3, has been shown to significantly reduce ischemic complications and clinical restenosis after high-risk angioplasty in the large-scale Evaluation of 7E3 for the Prevention of Ischemic Complications (EPIC) trial. A number of glycoprotein IIb/IIIa inhibitors have been tested in patients with unstable angina with similarly positive results, and initial trials in patients with acute myocardial infarction are also encouraging. Further evaluation of these agents in large scale trials is currently underway and should help determine the place and appropriate use of these agents in the clinical arena.
血小板在缺血性心脏病发病机制中的关键作用促使了控制血小板功能的新型药物的研发。血小板糖蛋白IIb/IIIa受体介导血小板聚集的最终共同途径。阻断糖蛋白IIb/IIIa受体的药物能有效抑制血小板聚集。现已研发出单克隆抗体、环肽和肽衍生物糖蛋白IIb/IIIa抑制剂。在“7E3预防缺血性并发症大规模评估（EPIC）试验”中，单克隆抗体Fab片段、嵌合7E3已被证明可显著降低高危血管成形术后的缺血性并发症和临床再狭窄。多种糖蛋白IIb/IIIa抑制剂已在不稳定型心绞痛患者中进行测试，结果同样呈阳性，并且在急性心肌梗死患者中的初步试验也令人鼓舞。目前正在对这些药物进行大规模试验的进一步评估，这将有助于确定这些药物在临床领域的地位和恰当用途。
