College of Pharmacy, University of Nebraska Medical Center, 986145 Nebraska Medical Center, Omaha, NE, 68198-6145, USA.
Division of Cardiovascular Medicine, Duke University Medical Center, Duke Clinical Research Institute, Durham, DC, USA.
Cardiovasc Drugs Ther. 2017 Aug;31(4):433-444. doi: 10.1007/s10557-017-6749-7.
Although the rate of cardiovascular disease (CVD)-related mortality has declined over the last decade, it is still the leading cause of mortality in the USA, accounting for over 1.4 million deaths annually. In addition, total direct (primarily hospital admissions) and indirect costs of CVD in the US is over $316 billion annually and is expected to grow to over $918 billion by 2030. Much of the etiology of CVD is due to atherosclerosis and its thrombotic complications, and central to this is the role of platelets. Atherosclerosis is a systemic disease, with meaningful morbidity and mortality when present in the coronary, cerebral, or major peripheral arteries. The recommended antiplatelet therapy differs based on the vascular bed impacted, with the optimal antiplatelet therapy yet to be defined. The PARTHENON program is a series of completed and ongoing phase III clinical trials investigating the efficacy and safety of ticagrelor in atherosclerotic CVD in comparison with established antiplatelet therapy or placebo. The overall aim of the program is to determine if more potent antiplatelet therapy, with different pharmacology, may reduce cardiovascular events in patients with atherosclerotic disease.
尽管过去十年心血管疾病（CVD）相关死亡率有所下降，但它仍是美国的主要死因，每年导致超过 140 万人死亡。此外，美国每年 CVD 的直接（主要是住院治疗）和间接总成本超过 3160 亿美元，预计到 2030 年将增长到 9180 亿美元以上。CVD 的大部分病因是由于动脉粥样硬化及其血栓并发症，而血小板在其中起着核心作用。动脉粥样硬化是一种全身性疾病，当它存在于冠状动脉、大脑或主要外周动脉时，会导致严重的发病率和死亡率。根据受影响的血管床，推荐的抗血小板治疗有所不同，最佳抗血小板治疗仍有待确定。PARTHENON 计划是一系列已完成和正在进行的 III 期临床试验，旨在比较替格瑞洛在动脉粥样硬化性 CVD 中的疗效和安全性与已确立的抗血小板治疗或安慰剂。该计划的总体目标是确定不同药理学的更有效的抗血小板治疗是否可以减少动脉粥样硬化疾病患者的心血管事件。
