Michelson Alan D
Center for Platelet Function Studies, University of Massachusetts Medical School, Room S5-846, 55 Lake Avenue North, Worcester, MA 01655, USA.
Arterioscler Thromb Vasc Biol. 2008 Mar;28(3):s33-8. doi: 10.1161/ATVBAHA.107.160689. Epub 2008 Jan 3.
The P2Y12 antagonist clopidogrel has a well-established role as an antithrombotic agent in the settings of percutaneous coronary intervention and acute coronary syndromes. However, several challenges remain, including the relatively slow onset of action of clopidogrel and the phenomenon of clopidogrel response variability or "resistance". Novel P2Y12 antagonists, including prasugrel, AZD6140, and cangrelor, have a faster onset of action, as well as more potent, and less variable, inhibition of platelet function ex vivo. Whether this promise will be translated into clinical benefit for patients will be determined by the results of ongoing phase 3 clinical trials.
P2Y12拮抗剂氯吡格雷在经皮冠状动脉介入治疗和急性冠状动脉综合征中作为抗血栓药物具有公认的作用。然而，仍存在一些挑战，包括氯吡格雷起效相对较慢以及氯吡格雷反应变异性或“抵抗”现象。新型P2Y12拮抗剂，包括普拉格雷、AZD6140和坎格雷洛，起效更快，并且在体外对血小板功能的抑制更强、变异性更小。这种前景是否会转化为患者的临床获益将由正在进行的3期临床试验结果来决定。
