Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Cardiovascular Research Institute, Busan Paik Hospital, Busan, South Korea.
Int J Cardiol. 2013 Sep 20;168(1):207-11. doi: 10.1016/j.ijcard.2012.09.093. Epub 2012 Oct 26.
Both new dual antiplatelet therapy (DAT; aspirin and prasugrel) and triple antiplatelet therapy (TAT; aspirin, clopidogrel and cilostazol) are more potent than classic DAT (aspirin and clopidogrel). We compared the antiplatelet efficacy between new DAT and TAT in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary coronary percutaneous coronary intervention (PCI).
Forty patients who were eligible for primary PCI were prospectively randomized to DAT group (n=20) or TAT group (n=20) immediately after hospital arrival. The primary end point was P2Y12 reaction unit (PRU) determined with the VerifyNow P2Y12 point-of-care assay at the time of discharge.
PRU value at discharge was significantly lower in patients receiving DAT compared with that of TAT (84.5 ± 44.7 vs. 128.4 ± 74.9, p=0.032). Percent platelet inhibition was significantly higher for DAT compared with TAT at discharge (72.1 ± 12.2 vs. 57.5 ± 23.5, p=0.020). Inter-patient variability of PRU values at discharge was significantly smaller in patient taking DAT compared with TAT (p=0.026).
A new DAT is more potent antiplatelet therapy than TAT in patients with STEMI undergoing primary PCI.
新型双联抗血小板治疗（DAT；阿司匹林和普拉格雷）和三联抗血小板治疗（TAT；阿司匹林、氯吡格雷和西洛他唑）均比经典双联抗血小板治疗（DAT；阿司匹林和氯吡格雷）更有效。我们比较了在接受直接经皮冠状动脉介入治疗（PCI）的 ST 段抬高型心肌梗死（STEMI）患者中新型 DAT 和 TAT 的抗血小板疗效。
40 名符合直接 PCI 条件的患者在入院后立即前瞻性随机分为 DAT 组（n=20）或 TAT 组（n=20）。主要终点是通过即时检验（POC）VerifyNow P2Y12 血小板反应单位（PRU）测定在出院时的 P2Y12 反应单位（PRU）。
与 TAT 相比，DAT 组患者出院时的 PRU 值明显较低（84.5±44.7 与 128.4±74.9，p=0.032）。与 TAT 相比，DAT 组在出院时的血小板抑制率更高（72.1±12.2 与 57.5±23.5，p=0.020）。与 TAT 相比，DAT 组患者出院时 PRU 值的个体间变异性明显较小（p=0.026）。
与 TAT 相比，在接受直接 PCI 的 STEMI 患者中，新型 DAT 是一种更有效的抗血小板治疗方法。
