Wiviott Stephen D
Cardiovascular Division, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Cardiol Clin. 2008 Nov;26(4):629-37. doi: 10.1016/j.ccl.2008.07.003.
Platelet activation and aggregation play key roles in the management of ischemic complications of acute coronary syndromes and percutaneous coronary intervention. Dual antiplatelet therapy with aspirin and the thienopyridine clopidogrel has become the standard of care for prevention of such complications. Prasugrel, a novel thienopyridine antiplatelet agent, has been demonstrated to have favorable pharmacologic properties, including rapid onset and potent and consistent inhibition of platelet aggregation. When compared directly against clopidogrel in the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition with Prasugrel-Thrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38), prasugrel resulted in significant reductions in ischemic events including myocardial infarction and stent thrombosis, but with more bleeding.
血小板活化和聚集在急性冠状动脉综合征和经皮冠状动脉介入治疗的缺血性并发症管理中起着关键作用。阿司匹林与噻吩并吡啶类氯吡格雷的双联抗血小板治疗已成为预防此类并发症的标准治疗方法。普拉格雷是一种新型噻吩并吡啶类抗血小板药物，已被证明具有良好的药理学特性，包括起效迅速以及对血小板聚集的强效和持续抑制作用。在心肌梗死溶栓38试验（TRITON-TIMI 38）中，将普拉格雷与氯吡格雷直接比较时，普拉格雷可显著降低包括心肌梗死和支架血栓形成在内的缺血性事件，但出血更多。
