Bonello L, De Labriolle A, Scheinowitz M, Lemesle G, Roy P, Steinberg D H, Pinto Slottow T L, Pakala R, Pichard A D, Barragan P, Camoin-Jau L, Dignat-George F, Paganelli F, Waksman R
Washington Hospital Center, 110 Irving Street, NW, Suite 4B-1, Washington, DC 20010, USA.
Heart. 2009 Aug;95(15):1214-9. doi: 10.1136/hrt.2008.152660. Epub 2009 Feb 5.
Clinical trials have demonstrated the beneficial impact of clopidogrel in preventing major adverse cardiovascular events (MACE), particularly in patients undergoing percutaneous coronary intervention (PCI). The concept of biological clopidogrel resistance emerged with the finding of persistent platelet activation despite clopidogrel therapy in some patients. Further, a link between biological clopidogrel resistance and thrombotic recurrence after PCI was observed and a threshold of platelet reactivity (PR) for thrombotic events was suggested. Consistently, in recent trials, enhanced PR inhibition translated into a reduction in the rate of MACE after PCI. This review aims to present the emergence of the concept of PR monitoring in patients undergoing PCI following recent advances in this field.
临床试验已证明氯吡格雷在预防主要不良心血管事件（MACE）方面的有益作用，尤其是在接受经皮冠状动脉介入治疗（PCI）的患者中。尽管对某些患者进行了氯吡格雷治疗，但仍发现血小板持续活化，由此出现了生物性氯吡格雷抵抗的概念。此外，观察到生物性氯吡格雷抵抗与PCI后血栓复发之间存在联系，并提出了血栓事件的血小板反应性（PR）阈值。同样，在最近的试验中，增强的PR抑制转化为PCI后MACE发生率的降低。本综述旨在介绍在该领域取得最新进展后，PCI患者中PR监测概念的出现情况。
