Braunwald Eugene, Angiolillo Dominick, Bates Eric, Berger Peter B, Bhatt Deepak, Cannon Christopher P, Furman Mark I, Gurbel Paul, Michelson Alan D, Peterson Eric, Wiviott Stephen
TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, 350 Longwood Avenue, Boston, Massachusetts 02115, USA.
Clin Cardiol. 2008 Mar;31(3 Suppl 1):I17-20. doi: 10.1002/clc.20363.
Platelets play a central role in the atherosclerotic inflammatory response, thrombotic vascular occlusion, microembolization, vasoconstriction, and plaque progression. Persistent platelet activation poses a serious problem among patients with acute coronary syndromes (ACS) and those who have undergone percutaneous coronary intervention (PCI), placing them at risk for ischemic events and subacute stent thrombosis. Patients undergoing PCI are at risk for further ischemic events because of procedure-related platelet activation as well as the inherent persistent platelet hyperreactivity and enhanced thrombin generation associated with ACS. Persistent platelet activation following an acute coronary event and/or PCI supports incorporating antiplatelet strategies into the standard medical management of such patients. In this clinical setting, antiplatelet therapies are capable of improving outcomes. Aspirin, thienopyridines, and glycoprotein IIb/IIIa inhibitors, the 3 major pharmacologic approaches to persistent platelet activation, target various levels of the hemostatic pathways and thrombus formation.
血小板在动脉粥样硬化性炎症反应、血栓性血管闭塞、微栓塞、血管收缩和斑块进展中起核心作用。持续性血小板活化在急性冠状动脉综合征（ACS）患者和接受经皮冠状动脉介入治疗（PCI）的患者中是一个严重问题，使他们面临缺血事件和亚急性支架血栓形成的风险。接受PCI的患者因与手术相关的血小板活化以及ACS相关的固有持续性血小板高反应性和凝血酶生成增加而有发生进一步缺血事件的风险。急性冠状动脉事件和/或PCI后的持续性血小板活化支持将抗血小板策略纳入此类患者的标准医疗管理中。在这种临床情况下，抗血小板治疗能够改善预后。阿司匹林、噻吩吡啶类药物和糖蛋白IIb/IIIa抑制剂是针对持续性血小板活化的3种主要药物治疗方法，它们作用于止血途径和血栓形成的不同环节。
