险病人可考虑增加剂量?*PCI术后一定时间内使用双倍氯吡格雷(150mg/d),之后改为75mg/d?*换用替格瑞洛或普拉格雷Р*氯吡格雷无效风险大大增加,易发生心脑血管事件?*优先考虑换用新药替格瑞洛或普拉格雷?*PCI术后联用其他抗血小板药物,如西洛他唑,两联变三联抗血小板。РScott SA, Sangkuhl K, Gardner EE, et al. Clinical ics Implementation Consortium.Clinical ics Implementation Consortium guidelines for cytochrome P450-2C19 (CYP2C19) genotype and clopidogrel therapy. Clin Pharmacol Ther. 2011 Aug;90(2):328-32.РHolmes DR Jr, Dehmer GJ, Kaul S, et al. ACCF/AHA clopidogrel clinical alert: approaches to the FDA "boxed warning": a report of?the American College of Cardiology Foundation Task Force on clinical expert consensus documents and the American Heart Association ?endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol. ?2010 Jul 20;56(4):321-41.
全文预览
