One-quarter standard-dose ticagrelor better than standard-dose clopidogrel in Chinese patients with stable coronary artery disease: A randomized, single-blind, crossover clinical study
One-quarter standard-dose ticagrelor better than standard-dose clopidogrel in Chinese patients with stable coronary artery disease: A randomized, single-blind, crossover clinical study
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对于中国稳定型冠状动脉疾病患者，四分之一标准剂量替格瑞洛优于标准剂量氯吡格雷：一项随机、单盲、交叉临床研究
DOI：
10.1016/j.ijcard.2016.04.087
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发表时间：
2016-07-15
影响因子：
3.5
通讯作者：
Li, Y.
中科院分区：
文献类型：
--
作者：
He, M. J.;Liu, B.;Li, Y.
背景资料：在冠心病（CAD）患者中，与氯吡格雷相比，替格瑞洛已被证明能更快速、更有力地抑制血小板聚集。在我们之前的研究中，我们发现在中国非ST段抬高型ACS患者中，半剂量替格瑞洛对血小板聚集的抑制作用与标准剂量替格瑞洛相似，且作用明显强于氯吡格雷。因此，我们进行了这项研究，以观察四分之一标准剂量的替格瑞洛的疗效相比，标准剂量的氯吡格雷在中国稳定型CAD.Methods：在一项随机，单盲，交叉试验，30例稳定型CAD患者被随机分为四分之一标准剂量的替格瑞洛（22.5毫克BID 7天）或标准剂量的氯吡格雷（75毫克QD 7天）。经过2周的洗脱期后，患者转换了治疗方案。结果：替格瑞洛组血小板聚集率（PAgR）明显低于氯吡格雷组（17.70% ± 12.67% vs27.63% ± 13.10%，P < 0.05）;替格瑞洛组的%抑制水平显着高于氯吡格雷组（65.33% +/- 21.31% vs 36.23% +/-23.01%，P < 0.01）。替格瑞洛组的PRU值显著低于氯吡格雷组（87.03 ± 51.38 vs 163.77 ± 58.66，P < 0.01）。高血小板反应性（HPR）（>= 208 PRU）在替格瑞洛组为0%，在氯吡格雷组为16.67%.Conclusions：1/4标准剂量的替格瑞洛对中国稳定型冠心病患者的血小板抑制程度大于标准剂量的氯吡格雷。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background: Ticagrelor has been demonstrated to provide a more rapid and powerful inhibition of platelet aggregation compared with clopidogrel in coronary artery disease (CAD) patients. In our previous study, we found that half-dose ticagrelor produced similar inhibitory effects on platelet aggregation as standard-dose ticagrelor and exerted significantly stronger effects than clopidogrel in Chinese patients with non-ST-elevation ACS. Therefore, we performed this study to observe the efficacy of one-quarter standard-dose ticagrelor in comparison to standard-dose clopidogrel in Chinese patients with stable CAD.Methods: In a randomized, single-blind, crossover trial, 30 patients with stable CAD were randomized to one-quarter standard-dose ticagrelor (22.5 mg BID for 7 days) or standard-dose clopidogrel (75 mg QD for 7 days). Following a 2-week washout period, patients switched regimens. Light transmission aggregometry (LTA) and VerifyNow assay were used to measure platelet function.Results: The platelet aggregation rate (PAgR) was obviously lower with ticagrelor than clopidogrel (17.70% +/- 12.67% versus 27.63% +/- 13.10%, P < 0.05). The % inhibition levels in the ticagrelor group exhibited significantly greater than that in the clopidogrel group (65.33% +/- 21.31% versus 36.23% +/- 23.01%, P < 0.01). PRU values in the ticagrelor group were dramatically lower than that in the clopidogrel group (87.03 +/- 51.38 versus 163.77 +/- 58.66, P < 0.01). High-platelet reactivity (HPR) (>= 208 PRU) was 0% with ticagrelor and 16.67% with clopidogrel.Conclusions: One-quarter standard-dose ticagrelor provided greater degree of platelet inhibition than standard-dose clopidogrel in Chinese patients with stable CAD. (C) 2016 Elsevier Ireland Ltd. All rights reserved.