Zhang Junyan, Li Lingya, Chen Zhongxiu, He Yong
Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
Thromb J. 2024 Oct 11;22(1):90. doi: 10.1186/s12959-024-00658-9.
Recent years have seen ticagrelor, a potent P2Y12 inhibitor, emerge as a significant advancement in the peri-thrombolytic management of patients with ST-segment elevation myocardial infarction (STEMI), offering a promising alternative to traditional antiplatelet drugs like clopidogrel. This review critically examines the efficacy and safety of ticagrelor during the peri-thrombolytic phase in STEMI patients, drawing on evidence from key clinical trials such as TREAT and MIRTOS, as well as other relevant studies. These investigations underscore ticagrelor's superior platelet inhibition capabilities, which are crucial for minimizing thrombotic complications post-thrombolysis without increasing bleeding risks. Despite its potential, clopidogrel remains the guideline-recommended choice for such patients, leaving the appropriateness of ticagrelor in this context open to debate. By summarizing the current evidence and identifying gaps in our understanding, this study advocates for targeted research to clarify the long-term benefits and optimal deployment of ticagrelor, highlighting its evolving significance in cardiovascular care.
近年来，强效P2Y12抑制剂替格瑞洛已成为ST段抬高型心肌梗死（STEMI）患者溶栓治疗围手术期管理的一项重大进展，为氯吡格雷等传统抗血小板药物提供了一个有前景的替代方案。本综述批判性地审视了替格瑞洛在STEMI患者溶栓治疗围手术期的疗效和安全性，参考了TREAT和MIRTOS等关键临床试验以及其他相关研究的证据。这些研究强调了替格瑞洛卓越的血小板抑制能力，这对于在不增加出血风险的情况下将溶栓后血栓形成并发症降至最低至关重要。尽管替格瑞洛有其潜力，但氯吡格雷仍是这类患者指南推荐的选择，这使得替格瑞洛在这种情况下的适用性仍存在争议。通过总结当前证据并找出我们认识中的差距，本研究倡导进行有针对性的研究，以阐明替格瑞洛的长期益处和最佳应用方式，突出其在心血管护理中不断演变的重要性。
