Division of Cardiology, Terrence Donnelly Heart Center, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada.
Curr Vasc Pharmacol. 2019;17(2):119-122. doi: 10.2174/1389200219666180820114435.
Clopidogrel remains a widely used antiplatelet agent for patients with established or high risk of atherothrombotic disease, particularly those treated with coronary, carotid or peripheral endovascular stenting. Clopidogrel hypersensitivity is an uncommon but well established adverse drug reaction presenting a challenge for patient management. The clinical presentation ranges from focal or diffuse cutaneous manifestations in most patients to angioedema in some and a systemic immune response in rare cases. The treatment options include drug discontinuation with or without desensitization therapy, switching to alternate ADP receptor antagonists or administration of oral steroids while continuing clopidogrel in patients at high risk of adverse events with clopidogrel discontinuation. In this review the author describes the phenomenon of clopidogrel hypersensitivity, various treatment strategies.
氯吡格雷仍然是一种广泛用于患有动脉血栓形成疾病或有该疾病高风险的患者的抗血小板药物，特别是那些接受冠状动脉、颈动脉或外周血管腔内支架治疗的患者。氯吡格雷超敏反应是一种不常见但已明确的药物不良反应，对患者管理构成挑战。临床表现从大多数患者的局灶性或弥漫性皮肤表现到某些患者的血管性水肿，再到罕见情况下的全身性免疫反应。治疗选择包括停药和/或脱敏治疗、改用替代 ADP 受体拮抗剂或在氯吡格雷停药后发生不良事件风险高的患者中继续使用氯吡格雷的同时给予口服类固醇。在这篇综述中，作者描述了氯吡格雷超敏反应的现象，以及各种治疗策略。
