[1]周小琳 何泉.替格瑞洛在急性冠脉综合征合并慢性肾脏病患者中的应用研究进展[J].心血管病学进展,2019,(5):718-722.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.014]
 ZHOU Xiaolin,HE Quan.Ticagrelor in Acute Coronary Syndrome with Chronic Kidney Disease[J].Advances in Cardiovascular Diseases,2019,(5):718-722.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.014]
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替格瑞洛在急性冠脉综合征合并慢性肾脏病患者中的应用研究进展()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2019年5期
页码:
718-722
栏目:
综述
出版日期:
2019-08-25

文章信息/Info

Title:
Ticagrelor in Acute Coronary Syndrome with Chronic Kidney Disease
作者:
周小琳 何泉
(重庆医科大学附属第一医院心血管内科,重庆 400016)
Author(s):
ZHOU Xiaolin HE Quan
(Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016,China)
关键词:
替格瑞洛急性冠脉综合征慢性肾脏病
Keywords:
Ticagrelor Acute coronary syndrome Chronic kidney disease
DOI:
10.16806/j.cnki.issn.1004-3934.2019.05.014
摘要:
急性冠脉综合征是威胁人类健康的重大心血管疾病,但由于多数抗血小板药物经肾脏代谢,因此,慢性肾脏病合并急性冠脉综合征患者的抗血小板药物选择成为长期研究的热点。替格瑞洛由于特殊的药代动力学和药效学特征,在诸多临床研究中相比氯吡格雷体现出极大的优越性,能显著降低急性冠脉综合征合并慢性肾脏病患者的主要不良心血管事件发生率。现结合近年来国内外多项研究,对替格瑞洛在急性冠脉综合征合并慢性肾脏病中的临床研究进展做一综述。
Abstract:
Acute coronary syndrome(ACS) is a major cardiovascular disease with tremendous impact on human health. However, most antiplatelet drugs are metabolized by the kidneys, thus the selection of antiplatelet drugs in patients with chronic kidney disease(CKD) and ACS had become a hot research for a long time. Due to the special pharmacokinetic and pharmacodynamic characteristics, ticagrelor showed great advantages in many studies compared with clopidogrel, and it can significantly reduce the incidence of major adverse cardiovascular events in patients with ACS and CKD. Based on the recent studies all over the world, we reviewed the the advance of ticagrelor for ACS with CKD

参考文献/References:


[1] Fox CS, Muntner P, Chen AY, et al. Use of evidence-based therapies in short term outcomes of ST-segment elevation myocardial infarction and non-ST segment elevation myocardial infarction in patients with chronic kidney disease:a report from the National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network registry [J]. Circulation,2010,121(3):357-365.

[2] Baber U,Chandrasekhar J,Sartori S,et al. Associations between chronic kidney disease and outcomes with use of prasugrel versus clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention: A Report From the PROMETHEUS Study[J]. J ACC Cardiovasc Interv,2017,10(20):2017-2025.

[3] Edfors R,Sahlén A,Szummer K,et al. Outcomes in patients treated with ticagrelor versus clopidogrel after acute myocardial infarction stratified by renal function [J].Heart,2018,104(19):1575-1582.

[4] Bonello L,Anqiolillo DJ,Aradi D,et al. P2Y12-ADP receptor blockade in chronic kidney disease patients with acute coronary syndromes[J].Circulation,2018,138(15):1582-1596.

[5] Melloni C,Cornel JH,Hafley G,et al.Impact of chronic kidney disease on long-term ischemic and bleeding outcomes in medically managed patients with acute coronary syndromes:insights from the TRILOGY ACS Trial[J]. Eur Heart J Acute Cardiovasc Care,2016,5(6):443-454.

[6] Tantry US,Bonello L,Aradi D,et al.Consensus and update on the definition of on-treatment platelet reactivity to adenosine diphosphate associated with ischemia and bleeding[J]. J Am Coll Cardiol,2013,62(24):2261-2273.

[7] Stone GW,Witzenbichler B,Weisz G,et al. Platelet reactivity and clinical outcomes after coronary artery implantation of drug-eluting stents(ADAPT-DES):a prospective multicentre registry study[J].Lancet,2013,382(9892):614-623.

[8]Windecker S,Kolh P,Alfonso F,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)[J].Eur Heart J,2014,35(37):2541-2619.

[9] 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[J].J Am Coll Cardiol,2013,61(4):e78-e140.

[10] Husted S,van Giezen JJ. Ticagrelor:the first reversibly binding oral P2Y12 receptor antagonist [J]. Cardiovasc Ther,2009,27(4):259-274.

[11] Popma JJ,Berger P,Ohman EM,et al. Antithrombotie therapy during percutaneous coronary intervention:the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy[J].Chest,2004,126(3):57.

[12] Parikh PB,Jeremias A,Naidu SS,et al. Impact of severity of renal dysfunction on determinants of in-hospital mortality among patients undergoing percutaneous coronary intervention[J]. Catheter Cardiovasc Interv,2012,80(3):352-357.

[13] Chou MT,Wang JJ,Sun YM,et al. Epidemiology and mortality among dialysis patients with acute coronary syndrome:Taiwan National Cohort Study[J].Int J Cardiol,2013,167(6):2719-2723.

[14] Butler K,Teng R. Pharmacokinetics, pharmacodynamics, and safety of ticagrelor in volunteers with severe renal impairment[J]. J Clin Pharmacol,2012,52(9):1388-1398.

[15] 王喜梅,吴永健,杨跃进,等. 慢性肾功能不全与急性冠状动脉综合征的研究进展[J].心血管病学进展,2012,33(1):21-23.

[16] Baber U,Stone GW,Weisz G,et al. Coronary plaque composition, morphology, and outcomes in patients with and without chronic kidney disease presenting with acute coronary syndromes[J]. JACC Cardiovasc Imaging,2012,5(3 suppl):S53-S61.

[17] Takagi M,Wada H,Mukai K,et al. Increased activated protein C:protein C inhibitor complex and decreased protein C inhibitor levels in patients with chronic renal failure on maintenance hemodialysis[J]. Clin Appl Thromb Hemost,1999,5(2):113-116.

[18] Bonomini M,Dottori S,Amoroso L,et al. Increased platelet phosphatidylserine exposure and caspase activation in chronic uremia[J]. J Thromb Haemost,2004,2(8):1275-1281.

[19]Thijs A,Nanayakkara PW,Ter Wee PM,et al. Mild-to-moderate renal impairment is associated with platelet activation: a cross-sectional study[J]. Clin Nephrol,2008,70(4):325-331.

[20] Molino D,de Lucia D,Gaspare De Santo N. Coagulation disorders in uremia[J]. Semin Nephrol,2006,26(1):46-51.

[21] Landray MJ,Wheeler DC,Lip GY,et al. Inflammation,endothelial dysfunction, and platelet activation in patients with chronic kidney disease:the Chronic Renal Impairment in Birmingham(CRIB) study[J]. Am J Kidney Dis,2004,43(2):244-253.

[22] Wratten ML,Tetta C,de Smet R,et al. Uremic ultrafiltrate inhibits platelet-activating factor synthesis[J]. Blood Purif,1999,17(2-3):134-141.

[23] Thekkedath UR,Chirananthavat T,Leypoldt JK,et al. Elevated fibrinogen fragment levels in uremic plasma inhibit platelet function and expression of glycoprotein IIb-IIIa[J]. Am J Hematol,2006,81(12):915-926.

[24] Valgimigli M,Bueno H,Byrne RA,et al.2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS:the task force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology(ESC) and of the European Association for Cardio-Thoracic Surgery(EACTS) [J]. Eur Heart J,2018,39(3):213-260.

[25] Amsterdam EA,Wenger NK,Brindis RG,et al.2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines[J]. Circulation,2014,130(25):344-426.

[26]中国医师协会心血管内科医师分会血栓防治专业委员会,中华医学会心血管病分会介入学组,中华心血管病杂志编辑委员会.替格瑞洛临床应用中国专家共识[J]. 临床军医杂志,2016,44(5):444-453.

[27] James S,Budaj A,Aylward P,et al. Ticagrelor versus clopidogrel in acute coronary syndromes in relation to renal function: results from the Platelet Inhibition and Patient Outcomes (PLATO) Trial[J].Circulation,2010,122(11):1056-1067.

[28] Bonello L,Laine M,Lemesle G,et al. Meta-analysis of potent P2Y12-ADP receptor antagonist therapy compared to clopidogrel therapy in acute coronary syndrome patients with chronic kidney disease[J].Thromb Haemost,2018,118(10):1839-1846.

[29] Edfors R,Sahlen AS,Szummer KS. Outcomes in patients treated with ticagrelor versus clopidogrel after acute myocardial infarction in relation to renal function:1-year SWEDEHEART registry data[J]. Heart,2018,104(19):1575-1582.

[30] Wang H,Qi J,Li Y,et al. Pharmacodynamics and pharmacokinetics of ticagrelor versus clopidogrel in patients with acute coronary syndromes and chronic kidney disease[J]. Br J Clin Pharmacol,2018,84(1):88-96.

[31]Jeong KH,Cho JH,Woo JS,et al. Platelet reactivity after receiving clopidogrel compared with ticagrelor in patients with kidney failure treated with hemodialysis: a randomized crossover study[J]. Am J Kidney Dis,2015,65(6):916-924.

[32] Desai RJ,Spoendlin J,Mogun H,et al. Contemporary time-trends in use of antiplatelet agents among patients with acute coronary syndrome and comorbid diabetes mellitus or chronic kidney disease[J]. Pharmacotherapy,2017,37(10):1322-1327.

[33]Alexopoulos D,Xanthopoulou I,Plakomyti TE,et al.Ticagrelor in clopidogrel-resistant patients undergoing maintenance hemodialysis[J].Am J Kidney Dis,2012,60(2):332-333.

[34] 张雁,刘强,左辉华,等.替格瑞洛用于行 PCI 术的慢性肾功能不全急性冠脉综合征患者的临床研究[J].中国医药导刊,2017,19(11):1135-1138.

[35] Cannon CP,Harrington RA,James S,et al.Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study[J]. Lancet,2010,375(9711):283-293.

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更新日期/Last Update: 2019-12-23