CBS 2019
CBSMD教育中心
中 文

科学研究

Abstract

Recommended Article

Long-Term Effect of Ultrathin-Strut Versus Thin-Strut Drug-Eluting Stents in Patients With Small Vessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Subgroup Analysis of the BIOSCIENCE Randomized Trial Cardiovascular Biomarkers and Imaging in Older Adults: JACC Council Perspectives Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review A Randomized Trial to Assess Regional Left Ventricular Function After Stent Implantation in Chronic Total Occlusion The REVASC Trial Association of Thrombus Aspiration With Time and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction: A Post Hoc Analysis of the Randomized TOTAL Trial Percutaneous coronary intervention using a combination of robotics and telecommunications by an operator in a separate physical location from the patient: an early exploration into the feasibility of telestenting (the REMOTE-PCI study) Microthrombi As A Major Cause of Cardiac Injury in COVID-19: A Pathologic Study Considerations for Single-Measurement Risk-Stratification Strategies for Myocardial Infarction Using Cardiac Troponin Assays

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.