Se han estudiado varios fármacos coadyuvantes del intervencionismo percutáneo en el infarto agudo de miocardio con el objetivo de mejorar la perfusión tisular y el daño miocárdico isquémico asociado con la reperfusión mecánica.
Los fármacos antiplaquetarios, aspirina y clopidogrel, deben ser administrados lo más precozmente posible antes del intervencionismo. Entre los inhibidores de los receptores de la glucoproteína IIb/IIIa, el abciximab es el fármaco más estudiado. Su uso se asocia con un menor número de eventos y una mayor permeabilidad de la arteria antes del intervencionismo. La angioplastia facilitada con trombolíticos, un interesante concepto para generalizar la reperfusión mecánica en el infarto, requiere más estudios antes de su recomendación. Otros fármacos, como las heparinas de bajo peso molecular o la bivalirudina, estudiados en el síndrome coronario agudo sin elevación del segmento ST no lo han sido en el intervencionismo del infarto agudo de miocardio.
Palabras clave
Angioplastia coronaria
Infarto de miocardio
Inhibidores agregación plaquetaria
Aspirina
Heparina
Trombólisis
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