Xue H J, Shi J, Liu B, Wang D Y, Dong Z X, Guo H, Kong Y H, Sheng L, Shao Q, Sun D H, Zhang L, Pan Y J, Dong X W, Li J Q, Xue J Y, Zhou Y Y, Yang H P, Li Y
a Cardiovascular Department , The First Clinical Hospital, Harbin Medical University , Harbin , P. R . China.
Platelets. 2016 Jul;27(5):440-5. doi: 10.3109/09537104.2015.1135890. Epub 2016 Feb 2.
Ticagrelor is a novel direct-acting P2Y12 receptor antagonist used for preventing atherothrombotic events in patients with acute coronary syndromes (ACS). The current recommended dose is 90 mg bid, but a low dose of ticagrelor has not been previously studied in Chinese ACS patients. Therefore, we performed this study to observe the different effects of half- and standard-dose ticagrelor on platelet aggregation in Chinese patients with NSTE-ACS. Sixty-two NSTE-ACS subjects were assigned to half-dose ticagrelor (n = 20), standard-dose ticagrelor (n = 22) and clopidogrel (n = 20) groups. Five days after drug administration, VerifyNow P2Y12 assay was performed to test P2Y12 reaction units (PRU) and inhibition of platelet aggregation (IPA). High-platelet reactivity (HPR) was defined as a PRU > 208. The adverse events, including bleeding events and dyspnoea, were monitored throughout the study. PRU values in the half-dose (44.55 ± 32.88) and standard-dose (39.10 ± 40.02) ticagrelor were dramatically lower than those in the clopidogrel group (189.20 ± 65.22; P < 0.0001). The half-dose (84% ± 10%) and standard-dose (86% ± 13%) ticagrelor both showed greater IPA than clopidogrel (33% ± 20%; P < 0.0001). There were no significant differences in PRU and IPA between the two ticagrelor groups (P = 0.3085 and 0.4028, respectively). HPR rates were significantly lower in the two ticagrelor groups (0% for both) than those in the clopidogrel group (35%). In conclusion, half-dose ticagrelor had a similar inhibitory effect on platelet aggregation as standard-dose ticagrelor in Chinese patients with NSTE-ACS, which was significantly stronger than that of clopidogrel.
替格瑞洛是一种新型的直接作用于P2Y12受体的拮抗剂，用于预防急性冠脉综合征（ACS）患者的动脉粥样硬化血栓形成事件。目前推荐剂量为90毫克，每日两次，但低剂量替格瑞洛此前尚未在中国ACS患者中进行研究。因此，我们开展了这项研究，以观察半剂量和标准剂量替格瑞洛对中国非ST段抬高型ACS患者血小板聚集的不同影响。62名非ST段抬高型ACS受试者被分配到半剂量替格瑞洛组（n = 20）、标准剂量替格瑞洛组（n = 22）和氯吡格雷组（n = 20）。给药5天后，采用VerifyNow P2Y12检测法检测P2Y12反应单位（PRU）和血小板聚集抑制率（IPA）。高血小板反应性（HPR）定义为PRU > 208。在整个研究过程中监测不良事件，包括出血事件和呼吸困难。半剂量（44.55 ± 32.88）和标准剂量（39.10 ± 40.02）替格瑞洛组的PRU值显著低于氯吡格雷组（189.20 ± 65.22；P < 0.0001）。半剂量（84% ± 10%）和标准剂量（86% ± 13%）替格瑞洛的IPA均高于氯吡格雷（33% ± 20%；P < 0.0001）。两组替格瑞洛之间的PRU和IPA无显著差异（分别为P = 0.3085和0.4028）。两组替格瑞洛组的HPR率（均为0%）显著低于氯吡格雷组（35%）。总之，在中国非ST段抬高型ACS患者中，半剂量替格瑞洛对血小板聚集的抑制作用与标准剂量替格瑞洛相似，且显著强于氯吡格雷。
