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替格瑞洛与氯吡格雷在急性心肌梗死治疗中的比较

Ticagrelor versus clopidogrel in the management of acute myocardial infarction.

作者信息

Volney Candice, Collins Anthony, Adams Sarah

机构信息

Department of Physiology, Saba University School of Medicine, Edmonton, Alberta, Canada.

Department of Physiology, Saba University School of Medicine, Caribbean Netherlands.

出版信息

J Community Hosp Intern Med Perspect. 2019 Sep 5;9(4):314-318. doi: 10.1080/20009666.2019.1644915. eCollection 2019.

Abstract

: In the care of acute myocardial infarction, ticagrelor attenuates post-ischemic myocardial damage and inhibits platelet activity to a greater extent than clopidogrel. : Scholarly articles published in the last 10 years were compiled from a PubMed MeSH search focusing on acute coronary infarction and the antiplatelet therapies clopidogrel and ticagrelor. The databases used were PubMed, Google Scholar, Dynamed, and EBSCOhost. Eight articles were chosen based on subject matter related to the hypothesis, including cardioprotective effects, mortality benefits, platelet reactivity, angiographic effects, and electrocardiography changes. : Evidence from randomized clinical trials demonstrates that ticagrelor reduces infarct size, prevents remodeling, and reduces mortality rate after acute myocardial infarction to a greater extent than clopidogrel. However, some angiography studies show no difference between the two treatment regimes. Two articles show that ticagrelor is more effective in treating individuals with high platelet reactivity (HPR). In addition, there is some evidence of increased dyspnea and significant bleeding with ticagrelor. : Although there is growing evidence that ticagrelor is the better antiplatelet drug post-acute coronary infarction, more research needs to be done to determine the situations in which ticagrelor provides the optimal treatment regime in regards to cardioprotective effects, antiplatelet effects and an overall decrease in mortality. : Ticagrelor was found to be superior to clopidogrel in relation to cardioprotective effects, mortality, and antiplatelet activity.

摘要

在急性心肌梗死的治疗中,替格瑞洛比氯吡格雷更能减轻缺血后心肌损伤并抑制血小板活性。

通过PubMed医学主题词检索,收集了过去10年发表的有关急性冠状动脉梗死以及抗血小板治疗药物氯吡格雷和替格瑞洛的学术文章。所使用的数据库有PubMed、谷歌学术、Dynamed和EBSCOhost。根据与该假设相关的主题选择了8篇文章,包括心脏保护作用、死亡率获益、血小板反应性、血管造影效果和心电图变化。

随机临床试验的证据表明,与氯吡格雷相比,替格瑞洛在急性心肌梗死后能更大程度地缩小梗死面积、防止心肌重构并降低死亡率。然而,一些血管造影研究显示两种治疗方案之间没有差异。两篇文章表明,替格瑞洛在治疗高血小板反应性(HPR)个体方面更有效。此外,有一些证据表明替格瑞洛会增加呼吸困难和严重出血的发生率。

尽管越来越多的证据表明替格瑞洛是急性冠状动脉梗死后更好的抗血小板药物,但仍需要更多研究来确定在哪些情况下替格瑞洛在心脏保护作用、抗血小板作用和总体死亡率降低方面能提供最佳治疗方案。

研究发现,替格瑞洛在心脏保护作用、死亡率和抗血小板活性方面优于氯吡格雷。

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