Resumen
El ataque cerebrovascular (ACV) es una causa común de morbilidad y mortalidad en el mundo. La terapia trom- bolítica con (r-TPA), es la única terapia aprobada para el tratamiento del ACV y esta terapia solo se logra aplicar en el 2 % de los pacientes. Se necesitan nuevas modalidades terapéuticas en ACV que puedan usarse en un periodo entre 4,5 a 6 horas después de iniciados los síntomas y con menores complicaciones hemorrágicas, que las que se presentan con la terapia trombolítica.
Los inhibidores de glicoproteinas IIb/IIIa (IG), producen una rápida y efectiva inhibición de la agregación plaque- taria ayudando a preservar la microvasculatura y han demostrado propiedades neuroprotectoras. Los receptores de glicoproteina IIb/IIIa son los mas abundantes en las plaquetas y es sobre ellos que actúan los IG, dentro de los cuales cabe mencionar el abciximab, el tirofiban, y el eptifibatide.
Los IG, después de su éxito inicial en pacientes con síndromes coronarios agudos, se convirtieron en terapias prometedoras en pacientes con ACV, sin embargo el periodo de ventana, el tipo de ACV, el riesgo de hemorragia sintomática y asintomática no están claros en el momento. Esta revisión se enfoca en el uso de IG en ACV. El abciximab ha mostrado ser seguro y efectivo en series de casos y en algunos estudios, si embargo no ha mejorado el desenlace de los pacientes con ACV y esta asociado a una mayor tasa de sangrado. El tirofiban perece ser más seguro y efectivo en estudios iniciales, sin embargo se necesitan más ensayos para establecer su papel en ACV.
Citas
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