最新ACC/ESC血小板糖蛋白Ⅱb/Ⅲa抑制剂相关指南解读
方唯一,仇兴标
摘要(Abstract):
<正>抗血小板治疗是急性冠状动脉综合征(ACS)患者和经皮冠状动脉介入治疗(PCI)患者的治疗基石。血小板糖蛋白Ⅱb/Ⅲa受体介导的血小板聚集是血栓形成的最后共同途径。因此,血小板糖蛋白Ⅱb/Ⅲa抑制剂(GPI)成为治疗ACS和PCI患者的有效手段。但是,在降低缺血事件的同时增加出血风险一直是GPI的主要缺陷,而出血并发症有增加远期死亡率的可能。随着近期临床研究结果的公布,欧州心脏病学会(ESC)陆续发布了2011ESC非
关键词(KeyWords): 抗血小板治疗;血小板糖蛋白Ⅱb/Ⅲa抑制剂;指南解读
基金项目(Foundation): 上海市胸科医院科技发展基金(2014YZDH20201)
作者(Author): 方唯一,仇兴标
参考文献(References):
- [1]Hamm C,Bassand J,Agewall S,et al.ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation:The Task Force for the management of acute coronary syndromes(ACS)in patients presenting without persistent ST-segment elevation of the European Society of Cardiology(ESC).Eur Heart J,2011,32:2999-3054.
- [2]Steg P,James S,Atar D,et al.ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.Eur Heart J,2012,33:2569-2619.
- [3]Authors/Task Force members,Windecker S,Kolh P,et al.2014 ESC/EACTS Guidelines on myocardial revascularization:The Task Force on Myocardial Revascularization of the European Society of Cardiology(ESC)and the European Association for Cardio-Thoracic Surgery(EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions(EAPCI).Eur Heart J,2014,35:2541-2619.
- [4]Jneid H,Anderson J,Wrigh R,et al.2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/non-ST-elevation myocardial infarction(updating the 2007 guideline and replacing the 2011 focused update):a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.Circulation,2012,126:875-910.
- [5]O'Gara PT,Kushner FG,Ascheim DD,et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.Circulation,2013,127:e362-e425.
- [6]Levine G,Bates E,Blankenship J,et al.2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention:executive summary.A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions.Circulation,2011,124:2574-2609.
- [7]ESPRIT Investigators.Novel dosing regimen of eptifibatide in planned coronary stent implantation(ESPRIT):a randomised,placebo-controlled trial.Lancet,2000,356:2037-2044.
- [8]Valgimigli M,Biondi-Zoccai G,Tebaldi M,et al.Tirofiban as adjunctive therapy for acute coronary syndromes and percutaneous coronary intervention:a meta-analysis of randomized trials.Eur Heart J,2010,31:35-49.
- [9]Bhatt D,Topol E.Current role of platelet glycoproteinⅡb/Ⅲa inhibitors in acute coronary syndromes.JAMA,2000,284:1549-1558.
- [10]Kastrati A,Neumann F,Schulz S,et al.Abciximab and heparin versus bivalirudin for non-ST-elevation myocardial infarction.ISAR REACT 4 trial.N Engl J Med,2011,365:1980-1989.
- [11]Mehilli J,Kastrati A,Schuhlen H,et al.Randomized clinical trial of abciximab in diabetic patients undergoing elective percutaneous coronary interventions after treatment with a high loading dose of clopidogrel.Circulation,2004,110:3627-3635.
- [12]Cuisset T,Frere C,Quilici J,et al.GlycoproteinⅡb/Ⅲa inhibitors improve outcome after coronary stenting in clopidogrel nonresponders:a prospective,randomized study.JACC Cardiovasc Interv,2008,1:649-653.
- [13]Valgimigli M,Campo G,de Cesare N,et al.Intensifying platelet inhibition with tirofiban in poor responders to ASA,clopidogrel,or both agents undergoing elective coronary intervention:results from the Double-Blind,Prospective,Randomized Tailoring Treatment with tirofiban in patients showing resistance to ASA and/or resistance to Clopidogrel Study.Circulation,2009,119:3215-3222.
- [14]Fung A,Saw J,Starovoytov A,et al.Abbreviated infusion of eptifibatide after successful coronary intervention:the BRIEF-PCI(brief infusion of eptifibatide following percutaneous coronary intervention)randomized trial.J Am Coll Cardiol,2009,53:837-845.
- [15]Giugliano R,White J,Bode C,et al.(EARLY ACS Investigators)Early versus delayed,provisional eptifibatide in acute coronary syndromes.N Engl J Med,2009,360:2176-2190.
- [16]Stone G,Bertrand M,Moses J,et al.Routine upstream initiation vs.deferred selective use of glycoproteinⅡb/Ⅲa inhibitors in acute coronary syndromes:the ACUITY Timing trial.JAMA,2007,297:591-602.
- [17]Stone G,McL aurin B,Cox D,et al.Bivalirudin for patients with acute coronary syndromes.N Engl J Med,2006,355:2203-2216.
- [18]Kastrati A,Neumann F,Schulz S,et al.Abciximab and heparin versus bivalirudin for non-ST-elevation myocardial infarction.ISAR REACT 4 trial.N Engl J Med,2011,365:1980-1989.
- [19]Ellis S,Tendera M,de Belder M,et al.Facilitated PCI in patients with ST-elevation myocardial infarction.N Engl J Med,2008,358:2205-2217.
- [20]Herrmann H,Lu J,Brodie B,et al.Benefit of facilitated percutaneous coronary intervention in high-risk ST-segment elevation myocardial infarction patients presenting to no percutaneous coronary intervention hospitals.JACC Cardiovasc Interv,2009,2:917-924.
- [21]Stone G,Witzenbichler B,Guagliumi G,et al.Bivalirudin during primary PCI in acute myocardial infarction.N Engl J Med,2008,358:2218-2230.
- [22]Gu Y,Kampinga M,Wieringa W,et al.Intracoronary versus intravenous administration of abciximab in patients with STsegment elevation myocardial infarction undergoing primary percutaneous coronary intervention with thrombus aspiration:the Comparison of Intracoronary Versus Intravenous Abciximab Administration During Emergency Reperfusion of ST-Segment Elevation Myocardial Infarction(CICERO)trial.Circulation,2010,122:2709-2717.
- [23]De Luca G,Verdoia M,Suryapranata H.Benefits from intracoronary as compared to intravenous abciximab administration for STEMI patients undergoing primary angioplasty:a metaanalysis of 8 randomized trials.Atherosclerosis,2012,222:426-433.
- [24]Thiele H,Whrle J,Hambrecht R,et al.AIDA STEMI Trial Team Intracoronary versus intravenous bolus abciximab during primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction:a randomized trial.Lancet,2012,379:923-931.
- [25]Stone G,Maehara A,Witzenbichler B,et al.Intracoronary abciximab and aspiration thrombectomy in patients with large anterior myocardial infarction:the INFUSE-AMI trial.JAMA,2012,307:1817-1826.