CBS 2019
CBSMD教育中心
中 文

科学研究

Abstract

Recommended Article

A Genotype-Guided Strategy for Oral P2Y12 Inhibitors in Primary PCI Tissue characterisation of atherosclerotic plaque in the left main: an in vivo intravascular ultrasound radiofrequency data analysis The Hospital Readmissions Reduction Program Nationwide Perspectives and Recommendations: A JACC: Heart Failure Position Paper Potential protective mechanisms of green tea polyphenol EGCG against COVID-19 Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 randomised trials and 4880 patients 3D Printing and Heart Failure: The Present and the Future Left Main Revascularization With PCI or CABG in Patients With Chronic Kidney Disease: EXCEL Trial Significantly less inappropriate shocks in ischemic patients compared to non-ischemic patients: The S-ICD experience of a high volume single-center

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.