Olivier C B, Diehl P, Bode C, Moser M
Universitäts-Herzzentrum, Klinik für Kardiologie und Angiologie I, Universität Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland,
Herz. 2014 Nov;39(7):808-13. doi: 10.1007/s00059-014-4162-6.
Besides percutaneous coronary interventions, antiplatelet drugs are of overwhelming importance for patients with acute coronary syndrome (ACS). For ACS patients, the guidelines recommend treatment with acetylsalicylic acid and a P2Y12 receptor antagonist. The third generation P2Y12 receptor antagonists prasugrel and ticagrelor provide stronger platelet inhibition than clopidogrel and improve the clinical outcome in patients with ACS; however, it is still under discussion which P2Y12 antagonist fits best to which subgroup of ACS patients. This article summarizes current guidelines and antiplatelet treatment strategies for patients with non-ST-segment elevation (NSTE) ACS or ST-segment elevation myocardial infarction (STEMI). The information is mainly based on the recently published guidelines of the European Society of Cardiology on myocardial revascularization.
除经皮冠状动脉介入治疗外，抗血小板药物对急性冠状动脉综合征（ACS）患者至关重要。对于ACS患者，指南推荐使用阿司匹林和P2Y12受体拮抗剂进行治疗。第三代P2Y12受体拮抗剂普拉格雷和替格瑞洛比氯吡格雷具有更强的血小板抑制作用，并改善了ACS患者的临床结局；然而，哪种P2Y12拮抗剂最适合ACS患者的哪个亚组仍在讨论中。本文总结了非ST段抬高（NSTE）ACS或ST段抬高型心肌梗死（STEMI）患者的现行指南和抗血小板治疗策略。这些信息主要基于欧洲心脏病学会最近发布的心肌血运重建指南。
