Glanzmann's thrombasthenia (GT) is the result of the absence or of an altered and dysfunctional expression on the platelet membrane of the fibrinogen receptor (glycoprotein [GP] IIb/IIIa complex). Various molecular genetic mechanisms have been found to be responsible for this inherited disease. In a patient with a severe type of GT, we have found a splice variant in the GP IIIa gene that leads ...

This review covers new developments and their clinical implications in three areas: platelet antigen polymorphisms, inhibition of platelet glycoprotein IIb-IIIa, and autoimmune thrombocytopenia (ITP). In Section I, Dr. Kunicki reviews platelet polymorphisms and their clinical implications. A current tabulation of the numerous platelet antigens, both those that are platelet specific and not plat...

Recent advances in the development of i.v. platelet glycoprotein alphaIIb/beta3 integrin (GPIIb/IIIa) antagonists led to the development of either a class of small-molecular-weight antagonists with a short to ultra-short duration of antiplatelet effects (Integrelin, Tirofiban, DMP728) or a very long-acting antagonist (ReoPro). Thus the present study was undertaken to characterize the antiplatel...

Platelet activation and aggregation have been shown to play a central role in thromboembolic disorders (20,35,37). Platelets are activated by a variety of agonists. They adhere to the injured blood vessel walls and, subsequently, aggregate. These processes lead to the formation of occlusive thrombi in the lumen of the injured vessel (16,23,53). The efficacy of such common antiplatelet agents as...

Acute coronary syndromes constitute a spectrum of clinical conditions and can be divided into non-ST segment elevation (unstable angina and non-Q wave myocardial infarction) and ST segment elevation myocardial infarction. They are major causes of morbidity and mortality. Hospital admissions for unstable angina are increasing (estimated approximately 130 000 patients per year in the UK) and have...

Acute coronary syndromes constitute a spectrum of clinical conditions and can be divided into non-ST segment elevation (unstable angina and non-Q wave myocardial infarction) and ST segment elevation myocardial infarction. They are major causes of morbidity and mortality. Hospital admissions for unstable angina are increasing (estimated approximately 130 000 patients per year in the UK) and have...

Many therapeutic drugs have been identified that possess clinically important antiplatelet activity. Platelet inhibition can be achieved in numerous ways (Fig. 1), including inhibition of platelet cyclooxygenase, inhibition of ADP receptors or inhibition of the platelet glycoprotein (GP) IIb/ IIIa receptor. Pharmacological inhibition of platelet function can also be achieved by interference wit...

CONTEXT Thrombus formation on disrupted atherosclerotic plaque is the major cause of acute coronary events. Platelet inhibitors are the mainstay of drug therapy to reduce cardiac events in patients with acute coronary syndromes. The platelet glycoprotein (GP) IIb/IIIa receptor is the final common pathway of platelet aggregation. OBJECTIVES To review mechanisms of platelet activation and aggre...

CONTEXT The central role of platelet-rich thrombus in the pathogenesis of acute coronary syndromes (ACSs) is well-known. Glycoprotein IIb/IIIa (Gp IIb/IIIa) receptor antagonists are potent inhibitors of platelet function that may be expected to affect favorably the natural history of ACSs. OBJECTIVE To define the optimal role of Gp IIb/IIIa inhibitors in treatment strategies for ACSs. DATA ...