Trenk D, Nührenberg T, Stratz C, Valina C M, Hochholzer W
Klinik für Kardiologie und Angiologie II, Abteilung Klinische Pharmakologie, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Südring 15, 79189, Bad Krozingen, Deutschland,
Herz. 2014 Nov;39(7):790-7. doi: 10.1007/s00059-014-4151-9.
Dual antiplatelet therapy with low-dose acetylsalicylic acid (ASA) and an inhibitor of the P2Y12 adenosine diphosphate (ADP) receptor is the standard treatment for patients presenting with acute coronary syndrome (ACS) or undergoing elective coronary interventions according to the current guidelines published by the European Society of Cardiology (ESC). New generation P2Y12 inhibitors, such as prasugrel and ticagrelor exert stronger and more consistent inhibition of the P2Y12 receptor. In clinical studies enrolling patients with ACS these drugs decreased the incidence of ischemic events compared to the standard therapy with clopidogrel and ASA; however, this beneficial effect was associated with an increase in bleeding events. Alternative therapeutic approaches via addition of drugs with different modes of action showed an overall reduction of ischemic events but also failed to uncouple this beneficial effect from an increased bleeding risk.
根据欧洲心脏病学会（ESC）发布的现行指南，低剂量阿司匹林（ASA）与P2Y12二磷酸腺苷（ADP）受体抑制剂联合进行双重抗血小板治疗是急性冠状动脉综合征（ACS）患者或接受择期冠状动脉介入治疗患者的标准治疗方法。新一代P2Y12抑制剂，如普拉格雷和替格瑞洛，对P2Y12受体具有更强且更持久的抑制作用。在纳入ACS患者的临床研究中，与氯吡格雷和ASA的标准治疗相比，这些药物降低了缺血事件的发生率；然而，这种有益效果与出血事件的增加有关。通过添加具有不同作用方式的药物的替代治疗方法显示缺血事件总体减少，但也未能将这种有益效果与出血风险增加分开。
