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氯吡格雷治疗冠状动脉微血管疾病的研究

An Examination of Clopidogrel in the Treatment of Coronary Microvascular Disease.

作者信息

Iskandar Nicholas P, Reddy Akshay J, Dang Allen, Ghauri Muhammad S, Min Mildred, Bachir Mark, Bachir Alex, Wagh Himanshu, Tak Nathaniel, Brahmbhatt Hetal

机构信息

Medicine, Campbell University School of Osteopathic Medicine, Lillington, USA.

Medicine, California University of Science and Medicine, Colton, USA.

出版信息

Cureus. 2022 Aug 25;14(8):e28406. doi: 10.7759/cureus.28406. eCollection 2022 Aug.

Abstract

The ability of clopidogrel (Plavix) to work in tandem with aspirin in a dual therapy strategy to boost the anti-platelet therapeutic impact and diminish platelet aggregation induced by platelet receptor inhibition is one of its many key advantages. The researchers discovered that the average reduction in risk of adverse cardiovascular events related to Plavix much outweighed any potential systemic effects. The analysis also revealed that, even though treatment results for diabetic patients with coronary microvascular disease (CMD) are poorer, the dosage and administration of clopidogrel for dual therapy are not modified to address this issue. Although it has been established that the current standard of care for microvascular disease decreases damage, more study is necessary to ensure that this standard is enhanced. It may become more usual in the future to include patient groups in trials who do not have diabetes as a criterion. Patients with diabetes often have higher low-density lipoprotein (LDL) cholesterol levels than the general population, therefore, it is possible that the research findings are flawed. To confirm or reject this assumption, further research is necessary.

摘要

氯吡格雷(波立维)在双重治疗策略中与阿司匹林协同作用,增强抗血小板治疗效果并减少因血小板受体抑制引起的血小板聚集,这是其众多关键优势之一。研究人员发现,与波立维相关的不良心血管事件风险平均降低幅度远超过任何潜在的全身影响。分析还表明,尽管患有冠状动脉微血管疾病(CMD)的糖尿病患者的治疗效果较差,但双重治疗中氯吡格雷的剂量和给药方式并未因解决此问题而改变。虽然已确定目前微血管疾病的护理标准可减少损害,但仍需更多研究以确保该标准得到改进。未来可能会更普遍地将无糖尿病患者群体纳入试验。糖尿病患者的低密度脂蛋白(LDL)胆固醇水平通常高于普通人群,因此研究结果可能存在缺陷。为证实或反驳这一假设,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ffa/9509004/45b3081118dc/cureus-0014-00000028406-i01.jpg

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