PCI术后的血小板功能监测能否改善远期预后 临床患者对于口服抗血小板药物的反应千差万别,大约有1/3以上的PCI术后患者血小板并未得到充分的抑制 血小板功能监测为支架术后的个体化抗血小板治疗提供了新的思路 背景 1 2 Study patients(n=2440) coronary angiography Monitoring group(n=1213) conventional group(n=1227) platelet-function monitoring(VerifyNow assay) high reactivity adequate response aspirin clopidogrel intravenous aspirin GPIIb/IIIa inhibitor and loading dose of clopidogrel(600mg) or prasugrel(60mg) stent implantation stent implantation maintenance dose :clopidogrel 150mg or prasugel 10mg stent implantation at14 to 30 days after stent implantation monitoring group platelet –function monitoring high platelet reactivity with clopidogrel low platelet reactivity adequate response switch to prasugrel at a dose of 10mg or a 75mg increase in the maintenance of clopidogrel switch to clopidogrel at a maintenance dose of 75mg no change in treatment 结论 血小板功能监测指导下的个体化抗血小板治疗较未监测组,并未能改善PCI术后患者的临床预后 为什么ARCTIC研究中,个体化抗血小板治疗没能改善支架术后患者的远期预后?
