TLY. Currently there are no randomized data available about the effects of pretreatment with clopidogrel before PCI in patients with STEMI. Data with the use of clopidogrel in STEMI patients, PPCI in particular 5-HT Receptor are summarized in Table 1. 4th New drugs have antiplatelet st Amplifiers, such as clopidogrel Prasugrel is an inhibitor of the P2Y12 receptor, but due to metabolic differences in the generation of active metabolites, this inhibition occurs more quickly, consistently, and a gr Eren Ausma as the standard or high dose of clopidogrel. In particular, erm A dose of 60 mg prasugrel glicht faster, more consistent and gr Ere inhibition of platelet aggregation than clopidogrel 600 mg, with a significant effect 30 min after the administration of any detectable effect seen when prasugrel with clopidogrel. In the study of SWAP in patients on chronic therapy with clopidogrel after acute coronary event, a transition of clopidogrel and prasugrel with a further reduction of platelet function by one week associated with the dose of maintenance of prasugrel or was within 2 h with the administration of prasugrel . The pharmacokinetic and pharmacodynamic advantages of prasugrel compared with clopidogrel are of particular interest, if not the pre-m Is possible, and the rapid inhibition of platelet aggregation, as in the case of the ICPC is desirable. In the study to improve therapeutic outcomes by optimizing platelet inhibition with prasugrel thrombolysis in myocardial infarction 38 Documented study, prasugrel resulted in a reduction of kardiovaskul Inmajor Ren side effects, but at the cost of a increased Hte bleeding. In addition, post hoc analyzes found that patients with a history of isch Mix stroke / transient had net harm, w While the patients aged 75 years or a K Less than 60 kg body weight had no net benefit prasugrel treatment. Ish the U.S.
Food and Drug Administration approved prasugrel, but also integrates the above conclusions subgroup on its labeling, citing a explanation Tion against the use of prasugrel in patients with a history of Stroke / blood mix transition or pathological. In TRITON TIMI 38, among the 2438 enrolled patients with STEMI within 12 hours and undergo PPCI the prim Ren endpoint kardiovaskul Rem death, not t more harmful MI, or t more harmful stroke after 15 months Pimecrolimus occurred in 11.6% in the clopidogrel group and 10.2% in the prasugrel group, HR 0.87, p0.2662. A predetermined analysis showed a 45% reduction in stent thrombosis with prasugrel, p0.0476. No difference in TIMI major bleeding not related to bypass surgery between the two groups was observed. Ticagrelor is the first oral antagonist binding of F Is reversible P2Y12 receptor inhibition and rapid, large Ere and uniformly Igere platelet aggregation than clopidogrel offers. In patients with stable coronary heart disease, again U had a dose of 300 mg clopidogrel LD, ticagrelor treatment with more platelet inhibition by clopidogrel compared with clopidogrel treatment in both responders and nonresponders was connected. W During the change of therapy, produces rapid improvements of ticagrelor inhibition of platelet aggregation in both clopidogrel responders and nonresponders, w During the change of clopidogrel associated with a reduction in platelet aggregation inhibition was.
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