Department of Pharmacology, Catholic University School of Medicine, Rome, Italy.
Annu Rev Med. 2010;61:49-61. doi: 10.1146/annurev-med-020209-171035.
Mechanisms of platelet inhibition are reviewed with emphasis on the pharmacokinetic and pharmacodynamic determinants of clinical efficacy and safety of antiplatelet drugs. Current developments in antiplatelet therapy are discussed in relation to both primary and secondary prevention of atherothrombotic complications. Interindividual variability in response to antiplatelet agents and new drug targets are outlined within the context of optimizing the balance between the cardiovascular benefits and bleeding risks of antiplatelet therapy. Recent advances in the pharmacogenetics of thienopyridines open the realistic prospect of a personalized choice of the most appropriate antiplatelet agent and tailored dose adjustment for an individual patient.
本文重点阐述了血小板抑制的机制，分析了抗血小板药物的临床疗效和安全性的药代动力学和药效动力学决定因素。本文还讨论了抗血小板治疗在动脉血栓并发症的一级和二级预防中的最新进展。在优化抗血小板治疗的心血管获益与出血风险平衡的背景下，本文概述了抗血小板药物反应的个体差异和新的药物靶点。噻吩吡啶类药物的药物遗传学的最新进展为个体化选择最合适的抗血小板药物和为每位患者进行个体化剂量调整提供了现实的前景。
