Mahanonda N
Her Majesty's Cardiac Centre, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1998 Jan;81(1):42-6.
Efforts to improve Percutaneous Transluminal Coronary Angioplasty (PTCA) have resulted in the usage of new antiplatelets, and antithrombotic agents. These new agents may increase bleeding complications. However, EPIC, EPILOG and CAPTURE trials showed benefits of 7E3, a GPIIb/IIIa platelets receptor blocker, in high risk PTCA patients. On the other hand, direct thrombin inhibitors, Hirudin and Hirulog, did not clearly show any benefit when compared to heparin in patients with unstable angina undergoing PTCA. Combination of oral antiplatelets, ticlopidine and aspirin, is widely utilized following stent implantation. However, its benefit over aspirin alone has not been demonstrated. This article aims to review mechanisms and benefits of these new agents in cardiovascular field.
为改善经皮腔内冠状动脉成形术(PTCA)所做的努力已带来新型抗血小板药和抗血栓药的应用。这些新药可能会增加出血并发症。然而,EPIC、EPILOG和CAPTURE试验显示,GPIIb/IIIa血小板受体阻滞剂7E3对高危PTCA患者有益。另一方面,在接受PTCA的不稳定型心绞痛患者中,与肝素相比,直接凝血酶抑制剂水蛭素和希美加群并未明确显示出任何益处。口服抗血小板药噻氯匹定和阿司匹林联合用药在支架植入后被广泛使用。然而,其相对于单用阿司匹林的益处尚未得到证实。本文旨在综述这些新药在心血管领域的作用机制和益处。