CBS 2019
CBSMD教育中心
中 文

科学研究

Abstract

Recommended Article

Multicenter Registry of Real-World Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy: 1-Year Outcomes The Hybrid Approach to Chronic Total Occlusion Percutaneous Coronary Intervention: Update From the PROGRESS CTO Registry Sex Differences in Instantaneous Wave-Free Ratio or Fractional Flow Reserve–Guided Revascularization Strategy Drug-Coated Balloon Versus Drug-Eluting Stent for Small Coronary Vessel Disease: PICCOLETO II Randomized Clinical Trial Impact of stent deformity induced by the kissing balloon technique for bifurcating lesions on in-stent restenosis after coronary intervention Outcomes with drug-coated balloons in small-vessel coronary artery disease Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study Treatment of Drug-Eluting Stent In-Stent Restenosis With Drug-Eluting Balloons: A Systematic Review and Meta-Analysis

Review Article2018 Feb 27;20(2):17.

JOURNAL:Curr Treat Options Cardiovasc Med. Article Link

Contemporary Antiplatelet Pharmacotherapy in the Management of Acute Coronary Syndromes

Mangels DR, Nathan A, Kobayashi T et al. Keywords: ACS; Antiplatelet; Coronary; P2Y12; Pretreatment; Ticagrelor

ABSTRACT


PURPOSE OF REVIEW - Antiplatelet therapies are pivotal treatments in the management of acute coronary syndrome (ACS) with or without revascularization. In recent years, the use of P2Y12 antagonists prior to catheterization, so-called pretreatment, has been questioned, particularly in patients who may be at higher bleeding risks. The purpose of this review was to evaluate the current literature on contemporary and novel antiplatelet therapy in the pretreatment and treatment of ACS.


RECENT FINDINGS - The P2Y12 receptor antagonists are associated with substantial reductions in morbidity and mortality for all types of ACS but only clopidogrel and ticagrelor have sufficient evidence for use in the pretreatment setting. The data regarding prasugrel support the use in patients undergoing percutaneous intervention (PCI). The glycoprotein IIa/IIIb antagonists are the most optimal for use in high-risk ACS as an adjuvant therapy during and after PCI. In summary, although all P2Y12 antagonists have morbidity- and mortality-reducing effects in ACS, only clopidogrel and ticagrelor have sufficient evidence in the pretreatment setting. Newer antiplatelet therapies, most notably the protease-activated receptor 1 antagonists, are evolving and promising but are associated with greater bleeding risks.