Glycoprotein IIb/IIIa (GPIIb/IIIa) receptor inhibitors are direct-acting antiplatelet agents with the greatest potential efficacy in acute platelet-mediated thrombosis conditions [1] . A meta-analysis of randomized trials in acute coronary syndrome demonstrated that on a background of heparin and aspirin, GPIIb/IIIa inhibitors, compared to placebo, decreased the odds of death or myocardial infarction at 30 days (odds ratio 0.91, 95 % CI 0.84–0.98) [2] . This modest benefit was associated with an increased risk of major bleeding complications (2.4 % vs. 1.4 %, p < 0.01) [2] . However, most of these trials were conducted in an era preceding routine stenting and potent P2Y12 inhibitors. In the current era of drug-eluting stents, shorter revascularization times, and potent dual antiplatelet therapy, the potential benefits of GP2IIb/IIIa inhibitors have decreased, with a net increase in bleeding complications [34] . The FINESSE trial, a 3-arm study randomizing 2452 ST-elevation myocardial infarction (STEMI) patients comparing pre-percutaneous coronary intervention (PCI) half-dose reteplase with abciximab, abciximab alone, and placebo, demonstrated no difference in the composite primary endpoint at 90 days between the three groups. However, there was an increase in TIMI major and minor bleeding in both arms with GPIIb/IIIa inhibitors [5] . Considering these data, routine GPIIb/IIIa inhibitor use in acute coronary syndromes (ACS), particularly in STEMI, is not recommended [6] . However, GPIIb/IIIa inhibitors may be considered for bailout in case of no-reflow or thrombotic complications, although this practice is not based on randomized data [6] .