Antiplatelet and anticoagulant therapy in patients undergoing percutaneous transluminal coronary angioplasty
Review published in Cardiology clinics (1994)
Abstract
Although coronary angioplasty has been in clinical use for only 15 years, continued refinements in technique, instrumentation, and adjunctive therapy have led to high initial success rates despite broader patient selection and the increasing complexity of lesions attempted. Antiplatelet therapy in the form of 80 to 325 mg of aspirin begun before the procedure has been demonstrated to be of benefit in decreasing the acute complication rate associated with PTCA. In the future, this beneficial effect may be augmented by the addition of monoclonal antibody inhibitors to platelet membrane glycoprotein IIB/IIIa, possibly at the expense of a mild-to-moderate increase in bleeding complications. Although routine prolonged antithrombotic therapy has not been useful after uncomplicated angioplasty, there is evidence that antithrombotic therapy with heparin for 1 or more days before angioplasty will benefit patients with unstable angina or evidence of thrombus on angiography. Although patients with thrombus or coronary dissection after the procedure probably also benefit from extended heparin therapy, most trials have specifically excluded these patients from study. More potent and specific antithrombin and antiplatelet agents are currently being investigated in human trials and may further lower acute complication rates. Although platelets, thrombin, and mural thrombosis have all been implicated as factors in restenosis, the process itself remains incompletely understood, and no therapy has been shown to be of benefit in humans. The specific platelet IIb/IIIa inhibitors, hirudin, hirulog, and factor Xa inhibitors have all shown promise in animal models of restenosis, and ongoing or planned trials will define their efficacy in humans.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Although coronary angioplasty has been in clinical use for only 15 years, continued refinements in technique, instrumentation, and adjunctive therapy have led to high initial success rates.
Por qué esto importa para la hirudoterapia
Esta revisión examina el papel de las terapias antiplaquetarias y anticoagulantes—incluidos aspirina, heparina y agentes emergentes—en la reducción de complicaciones agudas tras la angioplastia coronaria. La hirudina, junto con hirulog e inhibidores del factor Xa, se menciona como que «ha mostrado resultados prometedores en modelos animales de reestenosis», anticipándose ensayos en humanos en curso o planificados para definir su eficacia. El resumen enfatiza que, a pesar de que las plaquetas, la trombina y la trombosis mural están implicadas en la reestenosis, ninguna terapia había demostrado aún beneficio en humanos en el momento de la redacción. Esto es de relevancia indirecta para el dominio de ASH, ya que posiciona a la hirudina entre los agentes antitrombóticos emergentes bajo investigación clínica activa. La advertencia clave es que se trata de un artículo de revisión, la hirudina solo se menciona de pasada y el resumen no aporta datos originales ni hallazgos específicos más allá de señalar su promesa en modelos animales.
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026