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本文引用的文献

1
Clopidogrel resistance in North Indian patients of coronary artery disease and lack of its association with platelet ADP receptors P2Y1 and P2Y12 gene polymorphisms.印度北部冠心病患者氯吡格雷抵抗现象及其与血小板 ADP 受体 P2Y1 和 P2Y12 基因多态性缺乏相关性。
Platelets. 2013;24(4):297-302. doi: 10.3109/09537104.2012.693992. Epub 2012 Jun 21.
2
Platelet reactivity and cardiovascular outcomes after percutaneous coronary intervention: a time-dependent analysis of the Gauging Responsiveness with a VerifyNow P2Y12 assay: Impact on Thrombosis and Safety (GRAVITAS) trial.经皮冠状动脉介入治疗后血小板反应性与心血管结局：VerifyNow P2Y12 检测评估反应性对血栓和安全性的影响（GRAVITAS）试验的时间依赖性分析。
Circulation. 2011 Sep 6;124(10):1132-7. doi: 10.1161/CIRCULATIONAHA.111.029165. Epub 2011 Aug 29.
3
Laboratory evaluation of clopidogrel responsiveness by platelet function and genetic methods.血小板功能和基因检测方法评估氯吡格雷反应性的实验室研究
Am J Hematol. 2011 Dec;86(12):1032-4. doi: 10.1002/ajh.22112. Epub 2011 Aug 2.
4
Prasugrel overcomes high on-clopidogrel platelet reactivity post-stenting more effectively than high-dose (150-mg) clopidogrel: the importance of CYP2C19*2 genotyping.普拉格雷优于高剂量（150mg）氯吡格雷，更有效地克服支架术后高氯吡格雷反应性血小板：CYP2C19*2 基因分型的重要性。
JACC Cardiovasc Interv. 2011 Apr;4(4):403-10. doi: 10.1016/j.jcin.2010.12.011.
5
Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial.急性冠状动脉综合征患者行经皮冠状动脉介入治疗时的双联（氯吡格雷标准剂量与双倍剂量和阿司匹林低剂量与高剂量）治疗（CURRENT-OASIS 7）：一项随机析因试验。
Lancet. 2010 Oct 9;376(9748):1233-43. doi: 10.1016/S0140-6736(10)61088-4.
6
Response to ticagrelor in clopidogrel nonresponders and responders and effect of switching therapies: the RESPOND study.氯吡格雷无反应者和有反应者对替卡格雷的反应及转换治疗的效果：RESPOND 研究。
Circulation. 2010 Mar 16;121(10):1188-99. doi: 10.1161/CIRCULATIONAHA.109.919456. Epub 2010 Mar 1.
7
Prasugrel compared with high-dose clopidogrel in acute coronary syndrome. The randomised, double-blind ACAPULCO study.普拉格雷与大剂量氯吡格雷治疗急性冠脉综合征的比较。随机、双盲的 ACAPULCO 研究。
Thromb Haemost. 2010 Jan;103(1):213-23. doi: 10.1160/TH09-07-0482. Epub 2009 Oct 26.
8
Platelet inhibition with cangrelor in patients undergoing PCI.在接受 PCI 治疗的患者中使用坎格雷洛进行血小板抑制。
N Engl J Med. 2009 Dec 10;361(24):2318-29. doi: 10.1056/NEJMoa0908628.
9
Dual antiplatelet drug resistance in patients with acute coronary syndrome.急性冠状动脉综合征患者的双重抗血小板药物抵抗
Indian Heart J. 2009 Jan-Feb;61(1):68-73.
10
Ticagrelor versus clopidogrel in patients with acute coronary syndromes.替格瑞洛与氯吡格雷用于急性冠脉综合征患者的比较
N Engl J Med. 2009 Sep 10;361(11):1045-57. doi: 10.1056/NEJMoa0904327. Epub 2009 Aug 30.

氯吡格雷抵抗：未来之路。

Clopidogrel resistance: the way forward.

作者信息

Ray Shuvanan

机构信息

Chief of Interventional Cardiology, Fortis Hospitals Limited, 730 Anandapur, Beside Calcutta International School, EM Bypass, Kasba, East Kolkata Township, Kolkata 700107, India.

出版信息

Indian Heart J. 2014 Sep-Oct;66(5):530-4. doi: 10.1016/j.ihj.2014.08.012. Epub 2014 Oct 7.

DOI:10.1016/j.ihj.2014.08.012
PMID:25443607
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4223168/
Abstract

Clopidogrel, a second generation thienopyridine has been the mainstay of ACS (Acute Coronary Syndrome) treatment for more than a decade. Clopidogrel Resistance has been associated with increased mortality in ACS patients with an increase in number of Stent Thrombosis. This review article tries to find out the causes of Clopidogrel Resistance, the main factors involving it, Laboratory evaluation of Clopidogrel Resistance. The overall incidence of Clopidogrel Resistance across the Globe & India has also been considered. The article also discusses the clinical significance of Clopidogrel Resistance & its relationship with adverse cardiovascular events. This review ends with the probable solutions to Clopidogrel Resistance & the new generation of antiplatelets which can be used for the same.

摘要

氯吡格雷，一种第二代噻吩并吡啶，十多年来一直是急性冠状动脉综合征（ACS）治疗的主要药物。氯吡格雷抵抗与ACS患者死亡率增加及支架血栓形成数量增多有关。这篇综述文章试图找出氯吡格雷抵抗的原因、涉及的主要因素、氯吡格雷抵抗的实验室评估。还考虑了全球及印度氯吡格雷抵抗的总体发生率。文章还讨论了氯吡格雷抵抗的临床意义及其与不良心血管事件的关系。这篇综述最后提出了氯吡格雷抵抗可能的解决方案以及可用于此的新一代抗血小板药物。