Van De Graaff E, Steinhubl S R
Department of Cardiology, Wilford Hall Medical Center, San Antonio, TX, USA.
Ann Med. 2000 Nov;32(8):561-71. doi: 10.3109/07853890008998836.
Platelets play a pivotal role in the pathophysiology of unstable angina, acute myocardial infarction, and complications following percutaneous coronary intervention. Three classes of platelet-inhibiting drugs, aspirin, thienopyridines and platelet glycoprotein IIb/ IIIa inhibitors, are now commonly used for the prevention and treatment of disorders of coronary artery thrombosis. For the last several decades aspirin has been the sole option for antiplatelet therapy in the treatment and prevention of the manifestations of cardiovascular disease. However, a wider selection of antiplatelet agents, including the thienopyridines (ticlopidine and clopidogrel) and the platelet glycoprotein (GP)IIb/IIIa receptor antagonists, are now available and provide clinicians with the opportunity to potentially improve upon the previous gold standard of aspirin. This review summarizes these drugs and the scientific data that have led to their use in primary and secondary prevention, unstable angina, myocardial infarction, and percutaneous coronary intervention.
血小板在不稳定型心绞痛、急性心肌梗死及经皮冠状动脉介入治疗后的并发症的病理生理学中起关键作用。目前,三类血小板抑制药物,即阿司匹林、噻吩吡啶类药物和血小板糖蛋白IIb/IIIa抑制剂,常用于预防和治疗冠状动脉血栓形成紊乱。在过去几十年中,阿司匹林一直是治疗和预防心血管疾病表现的抗血小板治疗的唯一选择。然而,现在有更多种类的抗血小板药物可供选择,包括噻吩吡啶类药物(噻氯匹定和氯吡格雷)和血小板糖蛋白(GP)IIb/IIIa受体拮抗剂,这为临床医生提供了潜在改善以往阿司匹林这一黄金标准的机会。本综述总结了这些药物以及促使它们用于一级和二级预防、不稳定型心绞痛、心肌梗死和经皮冠状动脉介入治疗的科学数据。