Platelet Glycoprotein IIb/IIIa Receptor Blockade and Low-Dose Heparin during Percutaneous Coronary Revascularization

New strategies for preventing ischemic complications during percutaneous coronary revascularization have focused on the platelet surface-membrane glycoprotein IIb/IIIa receptor. 1 In a previous large-scale trial (Evaluation of 7E3 for the Prevention of Ischemic Complications, or EPIC), blockade of this receptor by abciximab (c7E3 Fab, ReoPro, Centocor, Malvern, Pa.), a human–murine chimeric antibody Fab fragment, was shown to reduce the incidence of acute ischemic events by 35 percent among patients undergoing “high-risk” percutaneous coronary revascularization 2 but was accompanied by a doubling of the incidence of major bleeding complications. Important questions were thus raised regarding the balance between risk and benefit with glycoprotein . . .