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首页> 外文期刊>Journal of atherosclerosis and thrombosis. >Role of Platelets and Antiplatelet Therapy in Cardiovascular Disease
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Role of Platelets and Antiplatelet Therapy in Cardiovascular Disease

机译:血小板和抗血小板治疗在心血管疾病中的作用

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Platelets have a key role in normal hemostasis and in the pathogenesis of atherothrombotic events, such as acute coronary syndrome. Following plaque rupture, platelets adhere to the subendothelial matrix, become activated and then aggregate to form a prothrombotic surface that promotes clot formation and subsequently vascular occlusion. Multiple pathways are involved in platelet activation, including those activated by adenosine diphosphate (ADP), thromboxane A2, epinephrine, serotonin, collagen, and thrombin. Currently, two groups of inhibitors of platelet activation are approved for clinical use in patients with acute coronary syndromes: cyclooxygenase-1 inhibitors, namely aspirin, and oral ADP receptor antagonists such as clopidogrel. These agents have shown improved short- and long-term clinical outcomes but are associated with increased bleeding risk, and the rates of recurrent ischemic events remain high. These considerations underscore the need for novel antiplatelet agents that can provide greater reduction in recurrent atherothrombotic events without increasing the risk of bleeding. Several novel antiplatelet agents are currently under clinical development, such as more potent ADP receptor antagonists and protease-activated receptor-1 antagonists. This article provides an overview of the basic principles of platelet biology and the current status of knowledge on available oral antiplatelet therapy, as well as those under clinical development.
机译:血小板在正常止血和动脉粥样硬化血栓形成事件(例如急性冠状动脉综合征)的发病机理中具有关键作用。噬菌斑破裂后,血小板粘附于内皮下基质,被活化,然后聚集形成促血栓形成的前血栓表面,从而促进血管闭塞。血小板活化涉及多种途径,包括被二磷酸腺苷(ADP),血栓烷A2,肾上腺素,5-羟色胺,胶原蛋白和凝血酶活化的途径。目前,已批准将两组血小板活化抑制剂用于临床上的急性冠脉综合征患者:环氧合酶-1抑制剂(阿司匹林)和口服ADP受体拮抗剂(例如氯吡格雷)。这些药物已显示出改善的短期和长期临床结局,但与出血风险增加相关,并且复发性缺血事件的发生率仍然很高。这些考虑强调了对新的抗血小板药物的需求,该药物可以在不增加出血风险的情况下减少复发性动脉粥样硬化血栓形成事件。目前正在临床开发几种新型抗血小板药,例如更有效的ADP受体拮抗剂和蛋白酶激活的受体1拮抗剂。本文概述了血小板生物学的基本原理以及有关口服抗血小板治疗以及临床开发中的知识的现状。

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