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To the Editor:An intrinsic activating property of GPIIb/IIIa blockers as first described by us in 19981 is widely discussed as one potential contributing factor for the disappointing outcome of trials with oral GPIIb/IIIa blockers. In a recent article in Circulation , Frelinger et al2 question the existence of an activating property of GPIIb/IIIa blockers. However, several research groups were able to extend our knowledge about the activating effects of GPIIb/IIIa blockers, 3,4⇓ a fact that was not discussed by Frelinger et al.2 In addition, the authors’ own data2 provide evidence for the existence of an intrinsic activating property of GPIIb/IIIa blockers. In Figure 3, fibrinogen binding is induced by abciximab with a dose dependency typical for the intrinsic activating property of GPIIb/IIIa blockers, revealing maximal induction of fibrinogen binding at low concentrations of abciximab.The intrinsic activating effect of GPIIb/IIIa blockers may be more prominent if platelets are preactivated, as for example, by thrombin.2 Indeed, preactivation …

Activating Effects of GPIIb/IIIa Blockers: An Intrinsic Consequence of Ligand- Mimetic Properties