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Prasugrel so với Ticagrelor trong hội chứng mạch vành cấp: Nên chọn loại nào?
Tóm tắt
Các hội chứng mạch vành cấp (ACS) vẫn liên quan đến tỷ lệ bệnh tật và tử vong đáng kể. Liệu pháp chống kết tập tiểu cầu kép với clopidogrel và axit acetylsalicylic đã trở thành tiêu chuẩn điều trị cho bệnh nhân mắc ACS trong hai thập kỷ qua. Tuy nhiên, clopidogrel có những hạn chế bao gồm hiệu quả điều trị chậm, sự biến đổi lớn giữa các cá nhân về khả năng ức chế kết tập tiểu cầu hoặc giảm tác dụng trên tiểu cầu do tương tác với các loại thuốc khác hoặc đa hình gen. Do đó, các thuốc chống kết tập tiểu cầu mới đã được phát triển. Hai trong số các loại thuốc này, cụ thể là prasugrel và ticagrelor, đã được Cơ quan Dược phẩm Châu Âu (EMA) chấp thuận và hiện đã có mặt tại nhiều quốc gia châu Âu. Đối với mỗi chất, một "thử nghiệm lớn" đã được công bố. Cả hai tác nhân đều vượt trội rõ ràng so với clopidogrel và do đó nên được ưu tiên sử dụng cho bệnh nhân mắc ACS. Tuy nhiên, chưa có nghiên cứu nào so sánh trực tiếp hiệu quả cũng như tính an toàn của prasugrel và ticagrelor cho đến nay. Do đó, các bác sĩ lâm sàng sẽ được yêu cầu quyết định chọn loại nào trong thực tiễn hàng ngày. Mục tiêu của tài liệu này là tóm tắt các tài liệu hiện có và cung cấp hướng dẫn cho việc ra quyết định cá nhân giữa prasugrel và ticagrelor trong ACS trong thực tiễn hàng ngày.
Từ khóa
#hội chứng mạch vành cấp #clopidogrel #prasugrel #ticagrelor #liệu pháp chống kết tập tiểu cầu #hiệu quả #an toànTài liệu tham khảo
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