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首页> 外文期刊>Journal of thrombosis and thrombolysis >Prasugrel 5 mg inhibits platelet P-selectin and GPIIb-IIIa expression in very elderly and non elderly: results from the GENERATIONS trial, a pharmacodynamic study in stable CAD patients
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Prasugrel 5 mg inhibits platelet P-selectin and GPIIb-IIIa expression in very elderly and non elderly: results from the GENERATIONS trial, a pharmacodynamic study in stable CAD patients

机译：普拉格雷5 mg可抑制非常老和未老的血小板P-选择素和GPIIb-IIIa的表达：GENERATIONS试验的结果，该试验是针对稳定的CAD患者的药效学研究

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摘要

Platelet P-selectin and activated glycoprotein IIb-IIIa (GPIIb-IIIa) are markers of platelet activation and mediates platelet aggregation. Prasugrel (Pras) 5 mg may be used in very elderly (VE) acute coronary syndrome (ACS) patients undergoing PCI, but its effect on platelet P-selectin and activated GPIIb-IIIa in those patients is not known. Stable ACS patients, VE (78 +/- 5 years, n = 23) and non-elderly (NE) (55 +/- 5 years, n = 22) were randomized to Pras (5 or 10 mg) or clopidogrel (Clop) 75 mg during three 12-day periods. Platelet activation markers were measured by flow cytometry on unstimulated or stimulated (adenosine diphosphate (ADP) 20 mu M) platelets, before and after each dosing period.Results: At baseline there was no difference in platelet activation markers, either unstimulated or ADP-stimulated, between NE and VE. Pras 5 mg reduced both ADP-stimulated platelet P-selectin and activated GPIIb-IIIa in VE (p < 0.01 for both analyses) and NE (p < 0.001 and p < 0.05, respectively). Clop 75 mg had a similar effect as Pras 5 mg but did not significantly reduce activated GPIIb-IIIa in VE. Prasugrel 10 mg resulted in decreased platelet activation in both age groups compared to Clop 75 mg (p < 0.01).Conclusions: In VE and NE-patients, Pras 5 mg inhibited platelet P-selectin expression similar to Clop 75 mg and Pras 10 mg. Prasugrel 10 mg inhibited platelet P-selectin expression better than Clop 75 mg. Prasugrel 10 mg and 5 mg, but not Clop 75 mg, significantly inhibited activated GPIIb-IIIa in VE. This platelet reactivity data support the use of Pras 5 mg for VE patients.
机译：血小板P选择素和活化的糖蛋白IIb-IIIa（GPIIb-IIIa）是血小板活化的标志物，并介导血小板聚集。 Prasugrel（Pras）5 mg可用于接受PCI的非常年老（VE）的急性冠状动脉综合征（ACS）患者，但对这些患者的血小板P-选择蛋白和活化的GPIIb-IIIa的作用尚不清楚。稳定的ACS患者，VE（78 +/- 5岁，n = 23）和非老年（NE）（55 +/- 5岁，n = 22）被随机分配到Pras（5或10 mg）或氯吡格雷（Clop ）在三个12天中服用75毫克。在每次给药之前和之后，通过流式细胞术在未刺激或刺激的（20亿腺苷二磷酸腺苷（ADP））血小板上测量血小板激活标志物。结果：在基线时，未刺激或ADP刺激的血小板激活标志物无差异。在NE和VE之间。 Pras 5 mg减少了VE（两种分析的p <0.01）和NE（分别为p <0.001和p <0.05）的ADP刺激的血小板P选择素和活化的GPIIb-IIIa。 75 mg Clop具有与Pras 5 mg类似的作用，但并未显着降低VE中活化的GPIIb-IIIa。与Clop 75 mg相比，普拉格雷10 mg在两个年龄组中均导致血小板活化降低（p <0.01）。结论：在VE和NE患者中，Pras 5 mg抑制血小板P-选择素的表达与Clop 75 mg和Pras 10 mg相似。 。普拉格雷10 mg抑制血小板P-选择素表达的效果优于Clop 75 mg。普拉格雷10毫克和5毫克，而非克洛普75毫克，可显着抑制VE中活化的GPIIb-IIIa。该血小板反应性数据支持对VE患者使用Pras 5 mg。

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