老年患者对强大的P2Y12抑制剂反应过敏
David Mutschlechner1,2,3, Maximilian Tscharre4,5,6, Patricia Pia Wadowski7
1Department of Internal Medicine I, Cardiology and Intensive Care Medicine, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.
Research and practice in thrombosis and haemostasis
|April 3, 2025
概括
服用强效P2Y12抑制剂的老年患者表现出血小板聚合的减少,特别是那些服用普拉苏格雷尔的老年患者. 这突显了抗血小板治疗反应的年龄相关差异.
科学领域:
- 心脏病学 心脏病学
- 老年学是一门学科.
- 药理学 药理学是指药理学的学科.
背景情况:
- 衰老与血小板激活的改变有关,对ADP的反应增加,但对血栓的反应减少.
- 之前的研究在未接受抗血小板治疗的个体中发现了这些变化.
研究的目的:
- 评估在接受与强效P2Y12抑制剂的双抗血小板治疗的老年患者 (≥70岁) 的血小板聚合.
- 为了比较老年人和年轻患者对各种激动剂的反应.
主要方法:
- 使用多个电极聚合计测量了156名皮肤穿刺冠状动脉干预后患者的血小板聚合.
- 激动剂包括阿拉基酸 (AA),ADP,原蛋白,SFLLRN (PAR-1) 和AYPGKF (PAR-4).
- 患者接受了普拉苏格勒 (n=79) 或提卡格勒勒 (n=77).
主要成果:
- 总体而言,老年患者 (n=33) 与年轻患者相比,对AA,ADP和SFLLRN的聚合率较低.
- 接受普拉苏格雷尔治疗的老年患者 (n=13) 显示,与年轻患者相比,对所有测试的激动剂的聚合减少.
- 接受提卡格勒勒的老年患者 (n=20) 仅减少了ADP诱导的聚合;对其他激动剂的反应类似.
- 70岁以上的prasugrel使用者对AA,原和AYPGKF的聚合率低于同一年龄组的ticagrelor使用者.
结论:
- 接受强效P2Y12抑制剂的老年患者表现出增强的抑制ADP诱导的血小板聚合.
- 与年轻患者相比,在老年患者中使用普拉苏格勒与对阿拉基酸,原蛋白,SFLLRN和AYPGKF的反应减少有关.
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