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首页> 外文期刊>Journal of thrombosis and haemostasis: JTH >Platelet function, antiplatelet therapy and clinical outcomes: to test or not to test?
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Platelet function, antiplatelet therapy and clinical outcomes: to test or not to test?

机译:血小板功能,抗血小板治疗和临床结果:要测试还是不测试?

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When and how should we treat with antiplatelet drugs a patient with coronary heart disease or stroke? Is it necessary or at least useful to monitor by appropriate laboratory tests the degree of platelet inhibition during therapy with antiplatelet drugs'? When, in a patient under treatment with a given antiplatelet drug, one or more platelet function tests show poor or no inhibitory pharmacologic effect, should we either stop the treatment, or substitute the drug under use, or add a second antiplatelet compound? When we were asked these or other similar questions some years ago, we used to say that the answer could not be obtained from the laboratory, but only from the library, i.e. from the results of clinical trials and meta-analyses on the antithrom-botic efficacy of antiplatelet drugs . To contribute to thrombosis - we argued - it is not necessary that platelets hyperaggregate; it is sufficient that they simply aggregate. This view was shared by many investigators, as shown by the fact that no platelet marker was selected either by the European Concerted Action on Thrombosis or by the Progetto Lombardo Atero-Trombosi to predict the risk of future cardiovascular events in different clinical conditions. On the other hand, clinical trials on antiplatelet drugs were performed on patients or healthy subjects enrolled without any previous measurement of either their basal platelet function, or the individual platelet response to the drug under trial, as measured
机译:我们何时以及如何使用抗血小板药物治疗患有冠心病或中风的患者?在使用抗血小板药物治疗期间通过适当的实验室测试监测血小板抑制的程度是否必要或至少有用?如果在接受给定抗血小板药物治疗的患者中,一项或多项血小板功能测试显示出不良的或没有抑制药理作用,我们是否应该停止治疗,或替代正在使用的药物,或添加第二种抗血小板化合物?几年前,当我们被问到这些或其他类似问题时,我们曾经说不能从实验室获得答案,而只能从图书馆获得,即从抗血栓形成的临床试验和荟萃分析的结果抗血小板药的功效。我们认为,要促进血栓形成,血小板就不必过度聚集。他们简单地聚合就足够了。许多研究者对此观点表示赞同,这是因为欧洲血栓形成协同行动或Progetto Lombardo Atero-Trombosi均未选择血小板标记来预测未来在不同临床情况下发生心血管事件的风险。另一方面,对入组患者或健康受试者进行了抗血小板药物的临床试验,但未对其基础血小板功能或对试验药物的单个血小板反应进行任何先前的测量

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