在接受初级皮肤冠状动脉干预的ST段升高心肌梗塞患者中使用Cangrelor和粉碎的Ticagrelor抑制血小板
Francesco Franchi1, Fabiana Rollini1, Andrea Rivas1
1Division of Cardiology, University of Florida College of Medicine-Jacksonville.
Circulation
|January 12, 2019
概括
在初级穿皮冠状动脉干预过程中,康格洛尔有效地弥合了P2Y12抑制差距,并没有显示与蒂卡格洛尔的药物相互作用. 这种策略改善了ST段升高心肌梗塞患者的血小板抑制.
科学领域:
- 心脏病学
- 药理学
- 干预心脏病学
背景情况:
- 在接受初级穿皮冠状动脉干预 (P- PCI) 的ST升高心肌梗塞患者中,口服P2Y12抗剂显示出延迟的血小板抑制.
- 这种延迟为血栓并发症创造了一个窗口,需要改进周围P-PCI血小板抑制策略.
- 康格洛尔是一种静脉注射的P2Y12抑制剂,具有快速和强大的抗血小板作用,但其与Ticagrelor在P-PCI中的组合需要进一步研究.
研究的目的:
- 在接受P-PCI的患者中评估格与格联合的药理动力学效应.
- 在过渡期内评估康格雷罗和蒂卡格雷罗之间潜在的药物相互作用.
主要方法:
- 这是一项前性,随机,双盲,安慰剂控制的药理学研究.
- 接受P-PCI的50名患者接受了康格洛尔或安慰剂,以及提卡格洛尔加重剂量.
- 在8个时间点使用P2Y12反应单位 (VerifyNow) 和血小板反应指数 (血管扩展剂刺激的蛋白) 测量了血小板抑制.
主要成果:
- 康格洛尔可显著降低P2Y12反应单位从5分钟后,持续整个输液 (P<0. 001).
- 治疗期间高血小板反应率在康格洛尔组较低.
- 停止输注后没有观察到血小板反应的显著差异,这表明康格洛尔和蒂卡格洛尔之间没有药物相互作用.
结论:
- 在从口服P2Y12抑制剂如Ticagrelor转换到P-PCI时,Cangrelor有效地弥合了血小板抑制差距.
- 同时使用碎片的提卡格勒与格勒似乎是安全的,没有明显的药物相互作用.
- 需要进一步的临床试验来证实这些药理学发现的临床含义.
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