Third generation P2Y12 antagonists inhibit platelet aggregation more effectively than clopidogrel in a myocardial infarction registry
Third generation P2Y12 antagonists inhibit platelet aggregation more effectively than clopidogrel in a myocardial infarction registry
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DOI：
10.1160/th13-06-0508
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发表时间：
2014-02-01
影响因子：
6.7
通讯作者：
Moser, Martin
中科院分区：
文献类型：
--
作者：
Olivier, Christoph B.;Diehl, Philipp;Moser, Martin
目前心肌梗死后患者抗血小板治疗的标准包括P2Y（12）受体拮抗剂氯吡格雷、普拉格雷或替格瑞洛。本研究旨在比较氯吡格雷、普拉格雷和替格瑞在心肌梗死患者中的抗血小板作用。在一项单中心注册研究中，通过聚集法研究了氯吡格雷、普拉格雷和替格瑞在心肌梗死后患者中的抗血小板作用。用凝血酶受体激活肽（TRAP; 32 μ M）诱导全血血小板聚集能力。为了具体量化P2Y（12）拮抗剂的作用，用64 μ M二磷酸腺苷（ADP）刺激全血。ADP诱导的相对聚集（r-ADP-agg）被定义为ADP- trap比值，以反映P2Y（12）依赖性血小板抑制的个体程度。分析238例患者的血小板功能[氯吡格雷（n=58），普拉格雷（n=65），替格瑞洛（n=115）]。接受氯吡格雷患者的r-ADP-agg为35 +/- 14%，接受普拉格雷患者为28 +/- 10%，接受替格瑞洛患者为26 +/- 11%。接受普拉格雷（p=0.0024）或替格瑞洛（p=0.0024）治疗的患者r-ADP-agg显著降低
The current standard of antiplatelet therapy of patients after myocardial infarction includes the P2Y(12) receptor antagonists clopidogrel, prasugrel or ticagrelor. This study aimed to compare the antiplatelet effect of clopidogrel, prasugrel and ticagrelor in patients after myocardial infarction. In a single-centre registry the antiplatelet effect of clopidogrel, prasugrel and ticagrelor was investigated by aggregometry in patients after myocardial infarction. To assess the overall capacity of platelet aggregation whole blood was induced with thrombin receptor activating peptide (TRAP; 32 mu M). To specifically quantify the effect of P2Y(12) antagonists, whole blood was stimulated with 64 mu M adenosine diphophosphate (ADP). Relative ADP induced aggregation (r-ADP-agg) was defined as the ADP-TRAP ratio to reflect an individual degree of P2Y(12)-dependent platelet inhibition. Platelet function of 238 patients was analysed [clopidogrel (n=58), prasugrel (n=65), ticagrelor (n=115)]. The r-ADP-agg was 35 +/- 14% for patients receiving clopidogrel, 28 +/- 10% for patients receiving prasugrel and 26 +/- 11% for patients receiving ticagrelor. The r-ADP-agg was significantly lower in patients treated with prasugrel (p=0.0024) or ticagrelor (p