基于P2Y12反应单元监测切换抗血小板治疗普拉格雷耐药复发急性血栓1例

Q4 Medicine

Journal of Cardiology Cases Pub Date : 2025-05-01 DOI:10.1016/j.jccase.2025.01.006

Tomomi Watanabe MD, PhD, Satoshi Kobara MD, Ryosuke Amisaki MD, Kazuhiro Yamamoto MD, PhD, FJCC

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引用次数: 0

摘要

包括P2Y12抑制剂在内的双重抗血小板治疗是预防急性冠脉综合征支架血栓形成的强制性措施，普拉格雷在日本患者中比氯吡格雷更常用，因为其代谢谱较差。我们描述了一例患者普拉格雷耐药谁是切换到适当的抗血小板治疗基于血小板功能测试。尽管在日常实践中普拉格雷耐药很少见，血小板功能检测也不常见，但熟悉普拉格雷耐药的替代药物以及如何怀疑和治疗这些患者是很重要的。学习目的通过血小板功能试验（血小板聚集试验、VerifyNow等）评估抗血小板治疗效果。虽然不推荐常规使用血小板功能测试，但它可能对反复发生血栓事件的病例有用。

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Switching antiplatelet therapy based on P2Y12 reaction unit monitoring for recurrent acute thrombosis due to prasugrel resistance: A case report

Dual antiplatelet therapy including P2Y12 inhibitor is mandatory to prevent stent thrombosis in acute coronary syndrome and prasugrel is more frequently used in Japanese patients than clopidogrel due to its poor metabolizer profile. We describe a case of a patient with prasugrel resistance who was switched to an appropriate antiplatelet therapy based on platelet function testing. Although prasugrel resistance is rare and platelet function test is not common in daily practice, it is important to be familiar with alternative drugs for prasugrel resistance and how to suspect and treat these patients.