Schulz Stefanie, Angiolillo Dominick J, Antoniucci David, Bernlochner Isabell, Hamm Christian, Jaitner Juliane, Laugwitz Karl-Ludwig, Mayer Katharina, von Merzljak Barbara, Morath Tanja, Neumann Franz-Josef, Richardt Gert, Ruf Judith, Schömig Gisela, Schühlen Helmut, Schunkert Heribert, Kastrati Adnan
Deutsches Herzzentrum München, Technische Universität München, Munich, Germany,
J Cardiovasc Transl Res. 2014 Feb;7(1):91-100. doi: 10.1007/s12265-013-9527-3. Epub 2013 Dec 27.
In acute coronary syndromes (ACS), a dual antiplatelet regimen with an adenosine diphosphate (ADP) receptor antagonist plus aspirin has become the cornerstone of treatment. The third-generation thienopyridine prasugrel and the cyclopentyl-triazolo-pyrimidine ticagrelor provide a greater, more rapid and consistent platelet inhibition compared to their predecessor clopidogrel. Based on their advantages over clopidogrel in two landmark studies, both drugs received a class I recommendation for their use in ACS patients with and without ST segment elevation. Due to differences in ACS populations and conditions investigated, the relative merits of ticagrelor versus prasugrel in the treatment of ACS patients with planned invasive strategy cannot be reliably estimated from independent trials. To date, no direct head-to-head comparison of ticagrelor and prasugrel in terms of clinical outcome exists. The aim of this multicenter, randomized, open-label trial is to assess whether ticagrelor is superior to prasugrel in ACS patients with planned invasive strategy.
在急性冠脉综合征（ACS）中，使用二磷酸腺苷（ADP）受体拮抗剂加阿司匹林的双重抗血小板治疗方案已成为治疗的基石。与第一代噻吩并吡啶类药物氯吡格雷相比，第三代噻吩并吡啶类药物普拉格雷和环戊基三唑并嘧啶类药物替格瑞洛能提供更强、更迅速且更持久的血小板抑制作用。基于两项具有里程碑意义的研究中它们相对于氯吡格雷的优势，这两种药物在有或无ST段抬高的ACS患者中使用均获得了I类推荐。由于所研究的ACS人群和条件存在差异，无法从独立试验中可靠地评估替格瑞洛与普拉格雷在有计划侵入性策略的ACS患者治疗中的相对优势。迄今为止，尚无替格瑞洛和普拉格雷在临床结局方面的直接头对头比较。这项多中心、随机、开放标签试验的目的是评估在有计划侵入性策略的ACS患者中，替格瑞洛是否优于普拉格雷。
