The adjunct use of a glycoprotein IIb/IIIa inhibitor during PCI is effective and associated with improved in-hospital survival rates.49-52 However, the optimal timing of initiation of glycoprotein IIb/IIIa inhibitor therapy in patients with unstable angina or NSTEMI (ie, whether to administer therapy before or after PCI) and the optimal application of this therapy have not been determined.24,53 The 2011 guidelines on PCI from the American College of Cardiology Foundation/American Heart Association (ACC/AHA) support early administration of glycoprotein IIb/IIIa before catheterization for patients with unstable angina or NSTEMI undergoing PCI who are judged clinically to be at high risk of thrombotic events relative to bleeding risk.24 The guidelines further note that much of the research evaluating use of these agents for patients with STEMI was performed in the era before routine dual oral antiplatelet therapy and was evaluated largely by placebo-controlled comparisons.24