Efectos cardioprotectores del ticagrelor

Q4 Medicine
Lina Badimona , Gemma Vilahur
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引用次数: 0

Abstract

The development of platelet P2Y12 receptor inhibitors has made a crucial difference to the treatment of patients with acute coronary syndrome. In recent years, extensive evidence from both laboratory and clinical studies has established that platelet P2Y12 receptor inhibitors have pleiotropic effects as well as antiplatelet properties. One possible explanation is that the P2Y12 receptor is found on a wide variety of cells in addition to platelets and could, therefore, modulate the inflammatory response, endothelial function, vascular tone, and ischemia–reperfusion injury. Studies in various animal models and a number of clinical trials have demonstrated that the cardioprotective potential of platelet P2Y12 receptor inhibitors is mediated by a mechanism involving the activation of signaling pathways associated with endogenous myocardial protection (e.g. ischemic postconditioning). However, ticagrelor, unlike other P2Y12 receptor inhibitors, has been shown to influence an additional cardioprotective pathway involving mechanisms associated with the increased bioavailability of adenosine, a molecule that is mainly produced by endothelial cells in response to ischemia and which has several beneficial cardiovascular effects. This article briefly reviews the different mechanisms of action of various platelet P2Y12 receptor inhibitors and explores the cardioprotective effects exerted by these compounds in addition to their antiplatelet actions, particularly those effects associated with adenosine, which are uniquely induced by treatment with ticagrelor.

替格瑞洛的心脏保护作用
血小板P2Y12受体抑制剂的发展对急性冠脉综合征患者的治疗产生了至关重要的影响。近年来,来自实验室和临床研究的大量证据表明,血小板P2Y12受体抑制剂具有多效性和抗血小板特性。一种可能的解释是,P2Y12受体除了存在于血小板外,还存在于多种细胞中,因此可以调节炎症反应、内皮功能、血管张力和缺血再灌注损伤。各种动物模型和大量临床试验的研究表明,血小板P2Y12受体抑制剂的心脏保护潜力是由一种机制介导的,该机制涉及与内源性心肌保护相关的信号通路的激活(例如缺血后适应)。然而,与其他P2Y12受体抑制剂不同,替格瑞洛已被证明影响另一种心脏保护途径,涉及与腺苷生物利用度增加相关的机制,腺苷是一种主要由内皮细胞在缺血反应中产生的分子,具有几种有益的心血管作用。本文简要回顾了各种血小板P2Y12受体抑制剂的不同作用机制,并探讨了这些化合物除了抗血小板作用外所发挥的心脏保护作用,特别是与腺苷相关的作用,这些作用是由替格瑞洛治疗所独特诱导的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Revista Espanola de Cardiologia Suplementos
Revista Espanola de Cardiologia Suplementos Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
1
期刊介绍: Revista Española de Cardiología, is an international scientific journal dealing with cardiovascular medicine. Revista Española de Cardiología, the official publication of the Spanish Society of Cardiology, publishes research articles related to cardiovascular diseases. Articles are published in Spanish for the paper edition and in both Spanish and English in the electronic edition, which is available on the Internet. Regular sections include original articles reporting clinical or basic research, brief reports, review articles, editorials and letters to the Editor.
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