CBS 2019
CBSMD教育中心
中 文

科学研究

Abstract

Recommended Article

2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society Impact of intravascular ultrasound-guided percutaneous coronary intervention on long-term clinical outcomes in a real world population Comparison of intravascular ultrasound guided versus angiography guided drug eluting stent implantation: a systematic review and meta-analysis Derivation, Validation, and Prognostic Utility of a Prediction Rule for Nonresponse to Clopidogrel: The ABCD-GENE Score Impact of Myocardial Scar on Prognostic Implication of Secondary Mitral Regurgitation in Heart Failure Mechanical complications of everolimus-eluting stents associated with adverse events: an intravascular ultrasound study Assessment of coronary atherosclerosis by IVUS and IVUS-based imaging modalities: progression and regression studies, tissue composition and beyond Intravascular ultrasound predictors for edge restenosis after newer generation drug-eluting stent implantation

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.