Immunohematology and Transfusion Center, Department of Pathology and Laboratory Medicine, University Hospital of Parma, Italy.
Eur J Intern Med. 2009 Dec;20(8):733-8. doi: 10.1016/j.ejim.2009.09.005. Epub 2009 Oct 1.
Despite recent advances in the treatment of acute coronary syndromes (ACS), including dual antiplatelet therapy with aspirin and a thienopyridine during the acute phase and for secondary prevention, this condition remains a leading cause of morbidity and mortality. The limitations of the currently available antiplatelet agents have triggered the development of newer drugs. In this review we summarize the mechanisms of actions and results of current clinical trials of novel antiplatelet agents. These include prasugrel, a thienopyridine prodrug which has a mechanism similar to that of clopidogrel but superior pharmacokinetic features; ticagrelor, a non-thienopyridine that binds reversibly to the platelet P2Y(12) receptor; cangrelor, an intravenously administered analog of ticagrelor; the thrombin receptor antagonist SCH 53048; and terutroban (S18886), a thromboxane A(2) receptor inhibitor.
尽管急性冠状动脉综合征 (ACS) 的治疗方法最近有所进展，包括在急性期和二级预防中使用阿司匹林和噻吩吡啶的双联抗血小板治疗，但这种情况仍然是发病率和死亡率的主要原因。目前可用的抗血小板药物存在局限性，这促使开发了新型药物。在这篇综述中，我们总结了新型抗血小板药物的作用机制和当前临床试验结果。这些药物包括普拉格雷，一种噻吩吡啶前体药物，其作用机制与氯吡格雷相似，但药代动力学特征更优；替卡格雷洛，一种可逆结合血小板 P2Y(12)受体的非噻吩吡啶药物；坎格雷洛，替卡格雷洛的静脉内类似物；血栓素受体拮抗剂 SCH 53048；和替罗非班（S18886），一种血栓素 A(2)受体抑制剂。
