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坎格瑞洛为注射给药的P2Y_(12)血小板受体抑制剂,该药直接起效并且作用可逆,具有起效快、失效快的特点。欧洲药品管理局(European Medicines Agency,EMA)、美国食品药品监督管理局(Food and Drug Administration,FDA)分别于2015年3月和6月批准了坎格瑞洛用于临床治疗。大型随机双盲临床试验Champion Phoenix比较了注射坎格瑞洛与口服氯吡格雷用于需要行经皮冠脉介入治疗(percutaneous coronary intervention,PCI)患者的有效性和安全性。结果在随机分组后的48 h内,坎格瑞洛组的全因死亡、心肌梗死(myocardial infarction,MI)、缺血导致的血运重建或支架内血栓事件显著低于氯吡格雷组。严重或威胁生命的出血发生率,坎格瑞洛组与氯吡格雷组无明显差异。本文对坎格瑞洛药理学特性、临床有效性及不良反应进行综述。
Cangrelor is an injectable P2Y_ (12) platelet receptor inhibitor that works directly and reversibly, with rapid onset and rapid failure. The European Medicines Agency (EMA) and the Food and Drug Administration (FDA) approved the use of cangrelor in March and June 2015 for clinical treatment. A large, randomized double-blind clinical trial, Champion Phoenix, compared the efficacy and safety of injectable cangrelor with oral clopidogrel in patients undergoing percutaneous coronary intervention (PCI). Results All-cause death, myocardial infarction (MI), ischemia-induced revascularization or stent thrombosis in the canagliptin group were significantly lower than those in the clopidogrel group within 48 h after randomization. Serious or life-threatening bleeding rates were not significantly different between the cangrelor group and the clopidogrel group. This review summarizes the pharmacological properties, clinical efficacy and adverse reactions of cangrelor.