Department of Pharmacy, Royal Columbian Hospital, Fraser Health, New Westminster, British Columbia, Canada.
Can J Cardiol. 2011 Nov-Dec;27(6):869.e9-11. doi: 10.1016/j.cjca.2011.04.002. Epub 2011 Jul 24.
Clopidogrel has mostly replaced the use of ticlopidine due to its more favourable hematologic adverse event profile. Prasugrel is the newest thienopyridine approved for use in Canada. This case describes a patient who was diagnosed with an acute coronary syndrome and treated with bare metal stenting of his coronary artery. He was discharged home on clopidogrel therapy. Two weeks later he presented with severe neutropenia. Clopidogrel was discontinued and prasugrel was initiated. Neutrophil count gradually increased and returned to normal. In patients with neutropenia associated with clopidogrel therapy, prasugrel may be considered as an alternative.
氯吡格雷因其更有利的血液学不良事件谱而大多取代了噻氯匹定的使用。普拉格雷是加拿大最新批准用于临床的噻吩吡啶类药物。本病例描述了一位被诊断为急性冠状动脉综合征并接受冠状动脉金属裸支架置入术的患者。他出院时接受氯吡格雷治疗。两周后，他出现严重中性粒细胞减少。停用氯吡格雷并启用普拉格雷。中性粒细胞计数逐渐增加并恢复正常。对于伴有氯吡格雷治疗相关中性粒细胞减少的患者，可考虑将普拉格雷作为替代药物。
