Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN, USA.
Ann Pharmacother. 2011 Sep;45(9):1151-6. doi: 10.1345/aph.1Q141. Epub 2011 Aug 18.
Acute coronary syndrome (ACS) is a continuum of disease that includes non-ST-segment elevation ACS and ST-segment elevation myocardial infarction. The purpose of this article is to define the developing role of ticagrelor in ACS and compare it to currently available P2Y₁₂ receptor inhibitors. While clopidogrel remains the "workhorse" P2Y₁₂ receptor inhibitor for many patients with ACS and prasugrel has an established role in select situations, clinicians must now assimilate the evolving role of ticagrelor. Although ticagrelor offers important advances in the management of ACS (eg, reversibility), there are also notable clinical considerations (eg, unique adverse effects such as dyspnea). Based on the current evidence, we propose an algorithm to aid clinicians in the selection of a P2Y₁₂ receptor inhibitor for patients with ACS in various clinical situations.
急性冠状动脉综合征（ACS）是一种连续的疾病，包括非 ST 段抬高型 ACS 和 ST 段抬高型心肌梗死。本文旨在定义替格瑞洛在 ACS 中的作用，并将其与目前可用的 P2Y₁₂受体抑制剂进行比较。虽然氯吡格雷仍然是许多 ACS 患者的“主力”P2Y₁₂受体抑制剂，普拉格雷在某些情况下也有明确的作用，但临床医生现在必须了解替格瑞洛不断发展的作用。虽然替格瑞洛在 ACS 的治疗中提供了重要的进展（例如，可逆性），但也有显著的临床考虑因素（例如，独特的不良反应，如呼吸困难）。基于目前的证据，我们提出了一个算法，以帮助临床医生在各种临床情况下选择 P2Y₁₂受体抑制剂治疗 ACS 患者。
