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Platelet glycoprotein IIb/IIIa antagonists for acute ischemic stroke

From the Department of Neurology, Lausanne, Switzerland (Dr. Bogousslavsky) and Lilly Research Laboratories, Indianapolis, Indiana (Dr. Leclerc).

Address correspondence and reprint requests to Dr. Julien Bogousslavsky, Department of Neurology, CHUV CH-1011, Lausanne, Switzerland.

Although thrombolytic therapy is approved in several countries for treatment of ischemic stroke, only a small number of patients are eligible for treatment. Additional agents that could restore or improve cerebral flow are needed. Reperfusion agents such as platelet glycoprotein (GP) IIb/IIIa antagonists, alone or in combination with reduced doses of thrombolytic agents, have the potential for improving safety and efficacy compared with standard recombinant tissue plasminogen activator (rt-PA). In addition, GP IIb/IIIa antagonists may permit expansion beyond the current 3-hour window after symptom onset that is used for rt-PA. On the basis of experience in acute coronary syndromes, parenteral GP IIb/IIIa antagonists may have potential applications in the treatment of acute ischemic stroke and as adjunctive therapy to carotid angioplasty.

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