GP IIb/IIIa inhibitors for STEMI: still the gold standard or an old survivor?

Glycoprotein (GP) IIb\IIIa receptor plays a central role on platelets activation and its blockage has been a matter of interest since the beginning of percutaneous revascularization. After first promising trials, GP IIb\IIIa inhibitors (GPI) have been widely used in cath labs for about a decade, significantly improving prognosis for patients with STSegment Elevation Myocardial Infarction (STEMI). However, their utilization isn't exempt from risks, mainly in form of bleeding disorders, which can negatively affect patients' outcome. Moreover, routinary administration of thyenopiridines like clopidogrel and the introduction of new anticoagulants like bivalirudin significantly reduced indications for GPI. In this review, a risk/benefit evaluation GP IIb\IIIa inhibitors is presented and their indications for STEMI patients addressed to revascularization are discussed according to recent advances reported in literature.