Benefit from adding GP IIb/IIIa inhibitors to aspirin therapy is greatest

among those with highest-risk features (elevated biomarkers, diabetes,

undergoing revascularization) and in those not receiving adequate
pretreatment with clopidogrel or ticagrelor.
Common adverse events of GP IIb/IIIa inhibitors:

(1) Most common adverse effect is bleeding, with rates as low as 1.4% and
as high as 10.6%, depending on length of therapy and how bleeding rates
were accrued in the individual studies.
(2) Note that the smaller-molecule agents eptifibatide and tirofiban depend
on renal clearance; adjustment of the infusion is recommended to
decrease the risk of bleeding; monitor SCr (CrCl).
(3) All GP IIb/IIIa inhibitors can cause thrombocytopenia; monitor
hemoglobin (Hgb), hematocrit (Hct), and Plt. When administered with
UFH, rates of thrombocytopenia with either tirofiban or eptifibatide are
no greater than with UFH alone.
(4) Secondary to their short half-life, eptifibatide and tirofiban can be
reversed within a few hours by discontinuing the infusion and are
preferred (class IIb) in the NSTEACS guideline.
Fibrinolytics