Montalescot G
Pitié-Salpétrière Hospital, Paris, France.
Blood Coagul Fibrinolysis. 1999 Feb;10 Suppl 1:S71-5.
Platelets play a key role both in ischemic complications after percutaneous transluminal coronary angioplasty (PTCA) and in the pathogenesis of acute myocardial infarction (AMI). Until recently, there was no treatment to dissolve the platelet clot. Indeed, the plasminogen activators achieve fibrin lysis but their platelet activating side-effects and their prothrombotic effects led to failure in PTCA trials and to a significant rate of reocclusions in thrombolysis trials. A new class of platelet antagonists directed against the platelet membrane glycoprotein IIb/IIIa receptor has undergone extensive evaluation in the prevention of ischemic complications of PTCA. In contrast, its development in the treatment of AMI is just starting. This class of medications has the potential to improve clinical outcome of AMI treated either with primary angioplasty or with thrombolysis.
血小板在经皮腔内冠状动脉成形术（PTCA）后的缺血性并发症以及急性心肌梗死（AMI）的发病机制中均起着关键作用。直到最近，尚无溶解血小板凝块的治疗方法。实际上，纤溶酶原激活剂可实现纤维蛋白溶解，但其血小板激活副作用及其促血栓形成作用导致PTCA试验失败，并在溶栓试验中导致较高的再闭塞率。一类针对血小板膜糖蛋白IIb/IIIa受体的新型血小板拮抗剂已在预防PTCA缺血性并发症方面进行了广泛评估。相比之下，其在AMI治疗中的研发才刚刚起步。这类药物有可能改善接受直接血管成形术或溶栓治疗的AMI的临床结局。
