Yang Ji-Tong, Zhang Qiu-Juan, Li Hua, Liu Ming-Wei
Department of Clinical Medicine, Kunming Medical University, 651106 Kunming, Yunnan, China.
Department of Emergency, The First Affiliated Hospital of Kunming Medical University, 650032 Kunming, Yunnan, China.
Rev Cardiovasc Med. 2024 Dec 25;25(12):462. doi: 10.31083/j.rcm2512462. eCollection 2024 Dec.
Coronary atherosclerosis (or coronary heart disease [CHD]) is a common cardiovascular disease that seriously damages human health. Percutaneous coronary stent implantation represents the primary treatment option for severe CHD in clinical practice; meanwhile, dual antiplatelet therapy (DAPT) is widely used to reduce the risk of postoperative thrombosis. Although the mechanisms of action of the two most commonly used antiplatelet drugs, aspirin and clopidogrel, remain unclear, clinical studies have shown that some patients are susceptible to stent thrombosis-antiplatelet resistance (high on-treatment platelet reactivity [HTPR])-despite using these drugs. Therefore, screening for HTPR and formulating personalized antiplatelet therapies is necessary. Ticagrelor, indobufen, and rivaroxaban are the most common and safe antiplatelet drugs used in clinical practice, with broad application prospects. This review summarizes the mechanisms of action of existing antiplatelet drugs, reasons for personalized treatment, screening of antiplatelet reactions, and development of novel antiplatelet drugs.
冠状动脉粥样硬化（或冠心病[CHD]）是一种常见的心血管疾病，严重损害人类健康。经皮冠状动脉支架植入术是临床实践中治疗重度冠心病的主要选择；同时，双联抗血小板治疗（DAPT）被广泛用于降低术后血栓形成的风险。尽管两种最常用的抗血小板药物阿司匹林和氯吡格雷的作用机制尚不清楚，但临床研究表明，一些患者尽管使用了这些药物，仍易发生支架内血栓形成——抗血小板抵抗（高治疗中血小板反应性[HTPR]）。因此，筛查HTPR并制定个性化的抗血小板治疗方案是必要的。替格瑞洛、吲哚布芬和利伐沙班是临床实践中最常用且安全的抗血小板药物，具有广阔的应用前景。本文综述了现有抗血小板药物的作用机制、个性化治疗的原因、抗血小板反应的筛查以及新型抗血小板药物的研发。
