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与克洛皮多格勒相比,提卡格勒对周围动脉疾病患者的血小板抑制改善
Mounika Naidu Boya1, Isabella F Cieri1, Adriana Araceli Rodriguez Alvarez1
1Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA.
与克洛皮多格勒相比,提卡格勒在周围动脉疾病 (PAD) 患者中具有优异的血小板抑制作用. 这项研究突出了tcagrelor
科学领域:
- 心血管医学
- 药理学
- 血液学
背景情况:
- 克洛皮多格勒是一种P2Y12抑制剂,是周围动脉疾病 (PAD) 的标准,但在25%的患者中面临遗传抵抗.
- 另一个P2Y12抑制剂Ticagrelor在急性冠状动脉综合征中具有较好的结果.
- 蒂卡格洛尔缺乏正式的PAD适应症,因此需要对该组患者的疗效和安全性进行比较研究.
研究的目的:
- 在从阿司匹林 - 克洛皮多格雷尔切换到阿司匹林 - 蒂卡格雷尔的患者中比较血栓强度和血小板功能.
- 使用血小板映射 (TEG PM) 评估蒂卡格勒与克洛皮多格勒对血小板抑制和血栓动态的影响.
主要方法:
- 在从克洛皮多格雷尔转换为蒂卡格雷尔后的多个时间点进行TEG PM分析.
- 验证现在测试评估了克洛皮多格雷尔的耐药性.
- 统计分析包括描述性统计和Wilcoxon匹配对测试进行参数比较.
主要成果:
- 与克洛皮多格勒相比,蒂卡格勒的ADP介导最大幅度 (凝块强度) 显著降低 (50. 8mm与59. 5mm,p< 0. 0001) 和血小板抑制优异 (30. 90%与13. 40%,p= 0. 0001).
- 34. 6% 的患者表现出克洛皮多格勒耐药性 (P2Y12反应单位> 180).
- 发生的血栓事件较少 (克洛皮多格雷尔治疗2例),而出血事件较少 (蒂卡格雷尔治疗1例).
结论:
- 在重血管化后,蒂卡格洛尔在PAD患者中提供优异的血小板抑制作用.
- 克洛皮多格雷尔耐药性的高率表明,在这一群体中,提卡格雷勒具有潜在的临床优势.
- 需要进一步的研究来确定蒂卡格勒在PAD治疗中的作用.
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