a Faculté de pharmacie , Université de Montréal , Montréal , Québec , Canada.
b Faculté de médecine , Université de Montréal , Montréal , Québec , Canada.
Platelets. 2018 Mar;29(2):131-139. doi: 10.1080/09537104.2017.1320372. Epub 2017 Jun 19.
Dual antiplatelet therapy with aspirin and a P2Y12 receptor antagonist is currently the standard of care for the prevention of ischemic events in patients with acute coronary syndrome or undergoing percutaneous coronary intervention. Several studies have shown that not all patients benefit from the treatment to the same degree and demonstrated that high on-treatment platelet reactivity may be associated with an increased risk of thrombotic events, while low on-treatment platelet reactivity may be linked to a higher risk of bleeding. Personalized antiplatelet treatment strategies based on platelet function monitoring and genetic testing constitute a promising tool for the prevention of both stent thrombosis and bleeding events, but conclusive evidence that such approaches can improve clinical outcomes is lacking. This review presents the most recent studies on tailored antiplatelet therapy in the management of coronary heart disease, with a focus on the prognosis value of platelet function testing.
双联抗血小板治疗，即阿司匹林联合 P2Y12 受体拮抗剂，目前是急性冠脉综合征或经皮冠状动脉介入治疗患者预防缺血事件的标准治疗方法。多项研究表明，并非所有患者都能从治疗中获得同等程度的获益，且证实高血小板反应性可能与血栓事件风险增加相关，而低血小板反应性可能与出血风险增加相关。基于血小板功能监测和基因检测的个体化抗血小板治疗策略，是预防支架内血栓形成和出血事件的一种有前途的手段，但缺乏此类方法能改善临床结局的确凿证据。本综述介绍了冠心病管理中针对抗血小板治疗的最新研究，重点关注血小板功能检测的预后价值。
