替格瑞洛和普拉格雷用于急性冠状动脉综合征：一项单臂交叉血小板反应性研究。
Ticagrelor and prasugrel in acute coronary syndrome: a single-arm crossover platelet reactivity study.
作者信息
Verdoia Monica, Pergolini Patrizia, Nardin Matteo, Rolla Roberta, Suryapranata Harry, Kedhi Elvin, De Luca Giuseppe
机构信息
Department of Translational Medicine.
Clinical Chemistry, Azienda Ospedaliera-Universitaria 'Maggiore della Carità', Eastern Piedmont University, Novara, Italy.
出版信息
J Cardiovasc Med (Hagerstown). 2021 Sep 1;22(9):686-692. doi: 10.2459/JCM.0000000000001222.
AIM
To compare the degree of platelet inhibition between ticagrelor and prasugrel in patients undergoing percutaneous coronary intervention for acute coronary syndrome.
METHODS
Platelet function was assessed by impedance aggregometry after 30-90 days of therapy with acetylsalicylic acid and ticagrelor and over 15 days after switching to prasugrel. High-on-treatment platelet reactivity (HRPR) was defined for ADP test results above the upper limit of normal.
RESULTS
A total of 105 patients were included, 81.9% males and 33.3% people with diabetes, with a mean age of 60.8 ± 8.1 years. Mean platelet reactivity was not significantly different between the two antiplatelet strategies, as the prevalence of HRPR (8.6 vs 12.3%, P = 0.50). Switching between the two antiplatelet agents was safe and well tolerated, and effectively reduced platelet reactivity in over 95% of the patients (only 3.8% of the study population displaying ineffective response to both drugs).
CONCLUSION
Ticagrelor and prasugrel have a similar effect on platelet reactivity. Switching between the two drugs can be safely done.
目的
比较替格瑞洛和普拉格雷在接受经皮冠状动脉介入治疗的急性冠脉综合征患者中对血小板的抑制程度。
方法
在用阿司匹林和替格瑞洛治疗30 - 90天后以及换用普拉格雷治疗超过15天后，通过阻抗聚集法评估血小板功能。将ADP检测结果高于正常上限定义为高治疗期血小板反应性（HRPR）。
结果
共纳入105例患者，男性占81.9%，糖尿病患者占33.3%，平均年龄为60.8±8.1岁。两种抗血小板策略之间的平均血小板反应性无显著差异，HRPR的发生率分别为8.6%和12.3%（P = 0.50）。在两种抗血小板药物之间切换是安全且耐受性良好的，并且在超过95%的患者中有效降低了血小板反应性（仅3.8%的研究人群对两种药物均无反应）。
结论
替格瑞洛和普拉格雷对血小板反应性有相似的作用。两种药物之间的切换可以安全进行。
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