Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study)
Effects of ticagrelor monotherapy vs. clopidogrel monotherapy on platelet reactivity: a randomized, crossover clinical study (SINGLE study)
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替格瑞洛单药治疗与氯吡格雷单药治疗对血小板反应性的影响：一项随机、交叉临床研究（单项研究）
DOI：
10.1080/09537104.2022.2052036
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发表时间：
2022-04
期刊：
影响因子：
3.3
通讯作者：
Yue Li
中科院分区：
文献类型：
--
作者：
Meijiao He;Wei Yan;Yun Zhang;Yihui Kong;Xuejie Han;Jie Ren;Zhongyang Zhao;Guangzhong Liu;Jing Shi;Yue Li
越来越多的临床试验表明，在维持P2Y12抑制剂单药治疗的同时停用阿司匹林可以降低出血风险，而不会失去抗血栓作用。然而，没有数据表明接受替格瑞洛单药治疗的患者与氯吡格雷的血小板反应性。因此，我们进行了这项研究，观察替格瑞洛单药与氯吡格雷在中国慢性冠脉综合征患者中的疗效。这项随机、单盲、交叉试验招募了50名患者，他们接受替格瑞洛（90mg，每日两次，持续2周）或氯吡格雷（75mg，每日一次，持续2周）治疗。在2周的洗脱期后，两组患者进行交叉试验。采用光透射聚集法（LTA）和血栓弹性成像法（TEG）检测血小板反应性。替格瑞洛组ADP和AA血小板聚集率（PAgR）显著低于氯吡格雷组(PAgR: ADP 27.30%（7.30% ~ 42.635%）比35.55% (12.03% ~ 69.25%),P = 0.0254；PAgR AA, 77.80%(21.60% - -86.43%)和83.10% (67.13% - -87.20%),P = .0400)。两组间胶原蛋白和肾上腺素的PAgR差异无统计学意义。TEG试验显示，替格瑞洛组诱导血小板聚集抑制的ADP和AA显著高于氯吡格雷组[ADP%， 69.00% (59.68% ~ 88.95%) vs. 60.55% (35.98% ~ 78.35%), P = 0.0020；AA %, 53.65%(22.75% - -79.28%)和15.15% (5.75% - -70.25%),P = .0127]。替格瑞洛和氯吡格雷治疗时血小板反应性（HTPR）分别为2.17%和19.57%。替格瑞洛和氯吡格雷对AA的HTPR分别为50.00%和69.57%。替格瑞洛和氯吡格雷可抑制ADP和aa诱导的血小板聚集。此外，替格瑞洛单药比氯吡格雷单药具有更强的抑制作用（胶原蛋白和肾上腺素除外）。
Abstract Increasing clinical trials demonstrated that the discontinuation of aspirin while maintaining a P2Y12 inhibitor monotherapy could decrease the risk of bleeding without losing the antithrombotic effect. However, no data are available on the platelet reactivity of patients undergoing ticagrelor monotherapy vs. clopidogrel. Therefore, we performed this study to observe the efficacy of ticagrelor monotherapy vs. clopidogrel in Chinese patients with chronic coronary syndrome. This randomized, single-blinded, crossover trial enrolled 50 patients who were administered with ticagrelor (90 mg twice daily for 2 weeks) or clopidogrel (75 mg once daily for 2 weeks). Followed by a 2-week washout period, the two groups of patients underwent a crossover trial. Light transmission aggregometry (LTA) and thromboelastography (TEG) assays were used to test platelet reactivity. The platelet aggregation rate (PAgR) of ADP and AA was significantly lower with ticagrelor than clopidogrel (PAgR of ADP, 27.30% (7.30%-42.635%) vs. 35.55% (12.03%-69.25%), P = .0254; PAgR of AA, 77.80% (21.60%-86.43%) vs. 83.10% (67.13%-87.20%), P = .0400). There was no significant difference in PAgR of collagen and epinephrine between the two groups. The TEG assay showed that ADP and AA, which induced the inhibition of platelet aggregation, were significantly higher in the ticagrelor group than those in the clopidogrel group [ADP%, 69.00% (59.68%–88.95%) vs. 60.55% (35.98%–78.35%), P = .0020; AA%, 53.65% (22.75%–79.28%) vs. 15.15% (5.75%–70.25%), P = .0127]. High on-treatment platelet reactivity (HTPR) on ADP was 2.17% with ticagrelor and 19.57% with clopidogrel. HTPR on AA was 50.00% with ticagrelor and 69.57% with clopidogrel. Ticagrelor and clopidogrel caused the inhibition of ADP and AA-induced platelet aggregation. Moreover, ticagrelor monotherapy had a stronger inhibitory effect than clopidogrel monotherapy (except on collagen and epinephrine).
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影响因子：
37.8
作者：
Park, Duk-Woo;Kwon, Osung;Park, Seung-Jung
通讯作者：
Park, Seung-Jung
影响因子：
158.5
作者：
Mehran, R.;Baber, U.;Gibson, C. M.
通讯作者：
Gibson, C. M.
影响因子：
3.3
作者：
Aboyans, Victor;Ricco, Jean-Baptiste;Desormais, Ileana
通讯作者：
Desormais, Ileana
DOI：
10.1161/circinterventions.114.002232
发表时间：
2015-07
期刊：
Circulation: Cardiovascular Interventions
影响因子：
--
作者：
R. Waksman;Juan Maya;D. Angiolillo;G. Carlson;R. Teng;R. Caplan;K. Ferdinand
通讯作者：
R. Waksman;Juan Maya;D. Angiolillo;G. Carlson;R. Teng;R. Caplan;K. Ferdinand
DOI：
10.1016/s0145-4145(10)79913-5
发表时间：
2011
期刊：
Yearbook of Cardiology
影响因子：
--
作者：
B. Gersh
通讯作者：
B. Gersh