Biondi-Zoccai Giuseppe, Lotrionte Marzia, Gaita Fiorenzo
Giuseppe Biondi-Zoccai, Marzia Lotrionte, Fiorenzo Gaita, Division of Cardiology, University of Turin, San Giovanni Battista "Molinette" Hospital, 10126 Turin, Italy; Unit for Heart Failure and Cardiac Rehabilitation, Catholic University, 00136 Rome, Italy.
World J Cardiol. 2010 Jun 26;2(6):131-4. doi: 10.4330/wjc.v2.i6.131.
Clopidogrel is a mainstay in the treatment of patients with acute coronary syndromes or those receiving endovascular prostheses. However, its efficacy has been challenged in the recent past by studies suggesting variable individual responsiveness and by new, more potent competitors, such as prasugrel and ticagrelor. But what is the actual body of evidence in support of clopidogrel? Is there any dark side of the moon? What is the role of prasugrel, which has already been approved in Europe and in the United States? And what will be the future role of ticagrelor, when approved for routine clinical practice? We hereby concisely summarize the scope of this clinical choice, providing arguments in favor and against each of the three antiplatelet agents: clopidogrel, prasugrel, and ticagrelor.
氯吡格雷是治疗急性冠脉综合征患者或接受血管内假体植入患者的主要药物。然而，近期的研究对其疗效提出了挑战，这些研究表明个体反应存在差异，并且出现了新的、更有效的竞争药物，如普拉格雷和替格瑞洛。但支持氯吡格雷的实际证据有哪些？它是否存在不为人知的一面？已在欧洲和美国获批的普拉格雷的作用是什么？替格瑞洛获批用于常规临床实践后，其未来作用又将如何？在此，我们简要总结这一临床选择的范围，针对三种抗血小板药物（氯吡格雷、普拉格雷和替格瑞洛）分别给出支持和反对的理由。
