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抗血小板药物的临床研究进展(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第4期
页码:
463-469
栏目:
综述
出版日期:
2017-02-25

文章信息/Info

Title:
Clinical research progress of antiplatelet drugs
作者:
孙 雷1; 孙冬冬1; 王海昌1; 2
第四军医大学：1.西京医院心血管内科，陕西 西安 710032，2.唐都医院心血管内科，陕西 西安 710038
Author(s):
SUN Lei1;  SUN Dong-dong1;  WANG Hai-chang1; 2
1.Department of Cardiology, Xijing Hospital, Fourth Military University, Xi’an 710032, Shaanxi, China; 2.Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi’an 710038, Shaanxi, China
关键词:
急性冠脉综合征; 抗血小板治疗; 血小板
Keywords:
acute coronary syndrome;  antiplatelet therapy;  platelets
分类号:
R973.2
DOI:
-
文献标识码:
A
摘要:
急性冠脉综合征（ACS）是一种常见的心血管疾病，可导致心律失常、心力衰竭、猝死等并发症，严重影响患者的生活质量和寿命。冠状动脉粥样硬化是ACS的发病基础，而血小板在动脉粥样硬化形成过程中起着关键作用。因此，抗血小板治疗是冠心病治疗的基石。目前临床常用的抗血小板药物主要有：血栓素A2抑制剂、P2Y12受体拮抗剂及糖蛋白Ⅱb/Ⅲa抑制剂，另外，有多种新型抗血小板药物正在进行临床试验。本文将对抗血小板药物的临床应用进展进行综述。
Abstract:
Acute coronary syndrome (ACS) is a common cardiovascular disease, which can lead to complications such as arrhythmia, heart failure and sudden death, which all seriously affect the quality of life of patients. Coronary atherosclerosis is the pathogenetic basis of ACS and platelets play a key role in the formation of atherosclerosis. Therefore, antiplatelet therapy is the cornerstone of the treatment of coronary heart disease. The commonly used clinical antiplatelet drugs mainly include thromboxane A2 inhibitors, P2Y12 receptor antagonists and glycoprotein IIb/IIIa inhibitors, and a variety of new antiplatelet drugs are in clinical trials. This article will review the clinical application of antiplatelet drugs.

参考文献/References

[1]Hansson GK.Inflammation,atherosclerosis,and coronary artery disease[J].N Engl J Med,2005,352(16):1685-1895.
[2]Davì G,Patrono C.Platelet activation and atherothrombosis[J].N Engl J Med,2007,357(24):2482-2494.
[3]Wright RS,Anderson JL,Adams CD,et al.2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/ Non-ST-Elevation Myocardial Infarction(Updating the 2007 Guideline):a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J].Circulation,2011,123(18):2022-2060.
[4]Levine GN,Bates ER,Blankenship JC,et al.2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention:a Report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions[J].Circulation,2011,124(23):e574-e 651.
[5]Hamm CW,Bassand JP,Agewall S,et al.ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology(ESC)[J].Eur Heart J,2011,32(23):2999-3054.
[6]Wijns W,Kolh P,Danchin N,et al.Guidelines on myocardial revascularization[J].Eur Heart J,2010,31(20):2501-2555.
[7]Patrono C,García Rodríguez LA,Landolfi R,et al.Low-dose aspirin for the prevention of atherothrombosis[J].N Engl J Med,2005,353(22):2373-2383.
[8]Antithrombotic Trialists' Collaboration.Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death,myocardial infarction,and stroke in high risk patients[J].BMJ,2002,324(7329):71-86.
[9]Peters RJ,Mehta SR,Fox KA,et al.Clopidogrel in Unstable angina to prevent Recurrent Events(CURE)Trial Investigators.Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes:observations from the Clopidogrel in Unstable angina to prevent Recurrent Events(CURE)study[J].Circulation,2003,108(14):1682-1687.
[10]CURRENT-OASIS 7 Investigators, Mehta SR,Bassand JP,et al.Dose comparisons of clopidogrel and aspirin in acute coronary syndromes[J].N Engl J Med,2010,363(10):930-942.
[11]Krasopoulos G,Brister SJ,Beattie WS,et al.Aspirin“resistance”and risk of cardiovascular morbidity:systematic review and meta-analysis[J].BMJ,2008,336(7637):195-198.
[12]Gurbel PA,Bliden KP,DiChiara J,et al.Evaluation of doserelated effects of aspirin on platelet function:results from the AspirinInduced Platelet Effect(ASPECT)study[J].Circulation,2007,115(25):3156-3164.
[13]Cox D,Maree AO,Dooley M,et al.Effect of enteric coating on antiplatelet activity of low-dose aspirin in healthy volunteers[J].Stroke,2006,37(8):2153-2158.
[14]Maree AO,Curtin RJ,Chubb A,et al.Cyclooxygenase-1 haplotype modulates platelet response to aspirin[J].J Thromb Haemost,2005,3(10):2340-2345.
[15]Capodanno D,Patel A,Dharmashankar K,et al.Pharmacodynamic effects of different aspirin dosing regimens in type 2 diabetes mellitus patients with coronary artery disease[J].Circ Cardiovasc Interv,2011,4(2):180-187.
[16]Catella-Lawson F,Reilly MP,Kapoor SC,et al.Cyclooxygenase inhibitors and the antiplatelet effects of aspirin[J].N Engl J Med,2001,345(25):1809-1817.
[17]Storey RF,Newby LJ,Heptinstall S.Effects of P2Y(1)and P2Y(12)receptor antagonists on platelet aggregation induced by different agonists in human whole blood[J].Platelets,2001,12(7):443-447.
[18]Bertrand ME,Rupprecht HJ,Urban P,et al.CLASSICS Investigators.Double-blind study of the safety of clopidogrel with and without a loading dose in combination with aspirin compared with ticlopidine in combination with aspirin after coronary stenting:the clopidogrel aspirin stent international cooperative study(CLASSICS)[J].Circulation,2000,102(6):624-629.
[19]Cadroy Y,Bossavy JP,Thalamas C,et al.Early potent antithrombotic effect with combined aspirin and a loading dose of clopidogrel on experimental arterial thrombogenesis in humans[J].Circulation,2000,101(24):2823-2828.
[20]Angiolillo DJ,Fernandez-Ortiz A,Bernardo E,et al.Variability in individual responsiveness to clopidogrel:clinical implications,management,and future perspectives[J].J Am Coll Cardiol,2007,49(14):1505-1516.
[21]Ferreiro JL,Angiolillo DJ.Clopidogrel response variability:current status and future directions[J].Thromb Haemost,2009,102(1):7-14.
[22]Yusuf S,Zhao F,Mehta SR,et al.Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators.Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation[J].N Engl J Med,2001,345(7):494-502.
[23]Steinhubl SR,Berger PB,Mann JT III,et al.CREDO Investigators.Clopidogrel for the Reduction of Events During Observation.Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention:a randomized controlled trial[J].JAMA,2002,288(19):2411-2420.
[24]Chen ZM,Jiang LX,Chen YP,et al.COMMIT(ClOpidogrel and Metoprolol in Myocardial Infarction Trial)collaborative group.Addition of clopidogrel to aspirin in 45 852 patients with acute myocardial infarction: randomised placebo-controlled trial[J]. Lancet,2005,366(9497):1607-1621.
[25]Sabatine MS,Cannon CP,Gibson CM,et al.CLARITY-TIMI 28 Investigators.Addition of clopidogrel to aspirin and fibrinolytic therapy for myocardial infarction with ST-segment elevation[J].N Engl J Med,2005,352(12):1179-1189.
[26]Bhatt DL,Fox KA,Hacke W,et al.CHARISMA Investigators. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events[J].N Engl J Med,2006,354(16):1706-1717.
[27]Mehta SR,Tanguay JF,Eikelboom JW,et al.CURRENT-OASIS 7 trial investigators. Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes(CURRENT-OASIS 7):a randomised factorial trial[J].Lancet,2010,376(9748):1233-1243.
[28]Price MJ,Berger PB,Teirstein PS,et al.Standard-vs high-dose clopidogrel based on platelet function testing after percutaneous coronary intervention:the GRAVITAS randomized tria l[J].JAMA,2011,305(11):1097-1105.
[29]Angiolillo DJ,Capranzano P.Pharmacology of emerging novel platelet inhibitors[J].Am Heart J,2008,156(2 Suppl):S10-S15.
[30]Wiviott SD,Trenk D,Frelinger AL,et al.PRINCIPLE-TIMI 44 Investigators. Prasugrel compared with high loading- and maintenance-dose clopidogrel in patients with planned percutaneous coronary intervention: the prasugrel in comparison to clopidogrel for inhibition of platelet activation and aggregationthrombolysis in myocardial infarction 44 trial[J].Circulation,2007,116(25):2923-2932.
[31]Wiviott SD,Braunwald E,McCabe CH,et al.TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes[J].N Engl J Med,2007,357(20):2001-2015.
[32]Antman EM,Wiviott SD,Murphy SA,et al.Early and late benefits of prasugrel in patients with acute coronary syndromes undergoing percutaneous coronary intervention:a TRITON-TIMI 38(TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction)analysis[J].J Am Coll Cardiol,2008,51(21):2028-2033.
[33]Wiviott SD,Braunwald E,McCabe CH,et al.TRITON-TIMI 38 Investigators.Intensive oral antiplatelet therapy for reduction of ischaemic events including stent thrombosis in patients with acute coronary syndromes treated with percutaneous coronary intervention and stenting in the TRITON-TIMI 38 trial:a subanalysis of a randomised trial[J].Lancet,2008,371(9621):1353-1363.
[34]Wiviott SD,Braunwald E,Angiolillo DJ,et al.TRITON-TIMI 38 Investigators.Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-Thrombolysis in Myocardial Infarction 38[J].Circulation,2008,118(16):1626-1636.
[35]Montalescot G,Wiviott SD,Braunwald E,et al.TRITON-TIMI 38 investigators. Prasugrel compared with clopidogrel in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (TRITON-TIMI 38): double-blind, randomised controlled trial[J].Lancet,2009,373(9665):723-731.
[36]Roe MT,Armstrong PW,Fox KA,et al.Prasugrel versus Clopidogrel for Acute Coronary Syndromes without Revascularization[J].N Engl J Med,2012,367(14):1297-1309.
[37]Angiolillo DJ,Guzman LA.Clinical overview of promising nonthienopyridine antiplatelet agents[J].Am Heart J,2008,156:S23- S28.
[38]Gurbel PA,Bliden KP,Butler K,et al.Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease:the ONSET/ OFFSET study[J].Circulation,2009,120(25):2577-2585.
[39]Wallentin L,Becker RC,Budaj A,et al.PLATO Investigators.Ticagrelor versus clopidogrel in patients with acute coronary syndromes[J].N Engl J Med,2009,361(31):1045-1057.
[40]James SK,Roe MT,Cannon CP,et al.Ticagrelor versus clopidogrel in patients with acute coronary syndromes intended for non-invasive management:substudy from prospective randomised PLATelet inhibition and patient Outcomes(PLATO)trial[J].BMJ,2011,342:d3527.
[41]Bonaca MP,Bhatt DL,Cohen M,et al.Long-term use of ticagrelor in patients with prior myocardial infarction[J].N Engl J Med,2015,372(19):1791-1800.
[42]Mahaffey KW,Wojdyla DM,Carroll K,et al.Ticagrelor compared with clopidogrel by geographic region in the Platelet Inhibition and Patient Outcomes(PLATO)trial[J].Circulation,2011,124(5):544-554.
[43]Roffi M,Chew DP,Mukherjee D,et al.Platelet glycoprotein IIb/IIIa inhibition in acute coronary syndromes. Gradient of benefit related to the revascularization strategy[J].Eur Heart J,2002,23(18):1441-1448.
[44]Kastrati A,Mehilli J,Neumann FJ,et al.Intracoronary Stenting and Antithrombotic:Regimen Rapid Early Action for Coronary Treatment 2(ISAR-REACT 2)trial investigators.Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment:the ISAR-REACT 2 randomized trial[J].JAMA,2006,295(13):1531-1538.
[45]De Luca G,Navarese E,Marino P.Risk profile and benefits from GP IIb-IIIa inhibitors among patients with ST-segment elevation myocardial infarction treated with primary angioplasty:a meta-regression analysis of randomized trials[J].Eur Heart J,2009,30(6):2705-2713.
[46]Stone GW,Maehara A,Witzenbichler B,et al.INFUSE-AMI investigators. Intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction: the INFUSE-AMI randomized trial[J].JAMA,2012,307(17):1817-1826.
[47]Tello-Montoliu A,Jover E,Rivera J,et al.New perspectives in antiplatelet therapy[J].Curr Med Chem,2012,19(3).406-427.
[48]Chamorro A.TP receptor antagonism:a new concept in atherothrombosis and stroke prevention[J].Cerebrovasc Dis,2009,27(Suppl 3):20-27.
[49]Neri Serneri GG,Coccheri S,Marubini E,et al.Picotamide,a combined inhibitor of thromboxane A2 synthase and receptor, reduces 2-year mortality in diabetics with peripheral arterial disease:the DAVID study[J].Eur Heart J,2004,25(20):1845-1852.
[50]Van der Wieken LR,Simoons ML,Laarman GJ,et al.Ridogrel as an adjunct to thrombolysis in acute myocardial infarction[J].Int J Cardiol,1995,52(2):125-134.
[51]Gaussem P,Reny JL,Thalamas C,et al.The specific thromboxane receptor antagonist S18886:pharmacokinetic and pharmacodynamic studies[J].J Thromb Haemost,2005,3(7):1437-1445.
[52]Bousser MG,Amarenco P,Chamorro A,et al.PERFORM study investigators. Terutroban versus aspirin in patients with cerebral ischaemic events(PERFORM):a randomised,double-blind,parallel-group trial[J].Lancet,2011,377(9782):2013-2022.
[53]Ferreiro JL,Ueno M,Angiolillo DJ.Cangrelor:a review on its mechanism of action and clinical development[J].Expert Rev Cardiovasc Ther,2009,7(10):1195-1201.
[54]Bhatt DL,Lincoff AM,Gibson CM,et al.CHAMPION PLATFORM investigators. Intravenous platelet blockade with cangrelor during PCI[J].N Engl J Med,2009,361(24):2330-2341.
[55]Harrington RA,Stone GW,McNulty S,et al.Platelet inhibition with cangrelor in patients undergoing PCI[J].N Engl J Med,2009,361(24):2318-2329.
[56]Bhatt DL,Stone GW,Mahaffey KW,et al.Effect of platelet inhibition with cangrelor during PCI on ischemic events[J].N Engl J Med,2013,368(14):1303-1313.
[57]Ueno M,Rao SV,Angiolillo DJ.Elinogrel:pharmacological principles,preclinical and early phase clinical testing[J].Future Cardio,2010,6(4):445-453.
[58]Welsh RC,Rao SV,Zeymer U,et al.on behalf of the INNOVATE-PCI investigators.A randomized,double-blind, active-controlled phase 2 trial to evaluate a novel selective and reversible intravenous and oral P2Y12 inhibitor elinogrel versus clopidogrel in patients undergoing nonurgent percutaneous coronary intervention:the INNOVATE-PCI Trial[J].Circ Cardiovasc Interv, 2012, 5(3):336-346.
[59]Angiolillo DJ,Welsh RC,Trenk D,et al.Pharmacokinetic and pharmacodynamic effects of elinogrel:results of the platelet function substudy from the intravenous and oral administration of elinogrel to evaluate tolerability and efficacy in nonurgent percutaneous coronary intervention patients(INNOVATE-PCI)trial[J].Circ Cardiovasc Interv,2012,5(3):347-356.
[60]Angiolillo DJ,Capodanno D, Goto S.Platelet thrombin receptor antagonism and atherothrombosis[J].Eur Heart J,2010,31(1):17-28.

备注/Memo

备注/Memo:
收稿日期：2016-01-07.通讯作者：王海昌，主任医师，主要从事冠心病基础及临床研究 Email:wanghc@fmmu.edu.cn 共同通讯作者：孙冬冬，主治医师，主要从事冠心病疾病研究 Email：51483696@qq.com 作者简介：孙雷，住院医师，硕士 Email： 87163161@qq.com @qq.com
更新日期/Last Update: 1900-01-01