Kuliczkowski Wiktor, Witkowski Adam, Polonski Lech, Watala Cezary, Filipiak Krzysztof, Budaj Andrzej, Golanski Jacek, Sitkiewicz Dariusz, Pregowski Jerzy, Gorski Jacek, Zembala Marian, Opolski Grzegorz, Huber Kurt, Arnesen Harald, Kristensen Steen D, De Caterina Raffaele
3rd Department of Cardiology, Silesian Center for Heart Diseases, Zabrze, Poland.
Eur Heart J. 2009 Feb;30(4):426-35. doi: 10.1093/eurheartj/ehn562. Epub 2009 Jan 27.
Oral antiplatelet drugs are a cornerstone of modern pharmacotherapy in cardiovascular atherothrombotic diseases. The efficacy of acetylsalicylic acid (ASA, aspirin) and clopidogrel in decreasing the risk of adverse events in coronary heart disease patients has been well established in the past 20 years. Despite chronic oral antiplatelet therapy, a number of atherothombotic events continue to occur. In recent years, a number of reports in the literature have shown possible relationships between residual platelet activity, as measured with a variety of laboratory tests, and clinical outcome, raising the possibility that 'resistance' to oral antiplatelet drugs may underlie many such clinical adverse events. The present position paper, conveyed within a group of clinical cardiologists with expertise in thrombosis appointed by the Section of Cardiovascular Interventions of the Polish Cardiac Society, has been further elaborated and endorsed by the Working Group on Thrombosis of the European Society of Cardiology. It aims at summarizing the main findings in this complex area, issuing opinions in cases of high controversy, and fostering future research in this area to obtain reliable laboratory and clinical data for the resolution of the many problems still open.
口服抗血小板药物是现代心血管动脉粥样硬化血栓形成性疾病药物治疗的基石。在过去20年中,乙酰水杨酸(ASA,阿司匹林)和氯吡格雷在降低冠心病患者不良事件风险方面的疗效已得到充分证实。尽管进行了长期口服抗血小板治疗,但仍有一些动脉粥样硬化血栓形成事件继续发生。近年来,文献中的一些报告表明,通过各种实验室检测所测量的残余血小板活性与临床结局之间可能存在关联,这增加了口服抗血小板药物“抵抗”可能是许多此类临床不良事件背后原因的可能性。本立场文件由波兰心脏病学会心血管介入分会任命的一组具有血栓形成专业知识的临床心脏病专家传达,并得到了欧洲心脏病学会血栓形成工作组的进一步阐述和认可。其目的是总结这一复杂领域的主要发现,在存在高度争议的情况下发表意见,并推动该领域的未来研究,以获得可靠的实验室和临床数据,解决许多仍未解决的问题。