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[ESC2012]普拉格雷在很多情况下优于氯吡格雷——Franz-Josef Neumann教授专访
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<International Circulation>:In the TRITON trial, the bleeding risk was found to be higher with prasugrel when compared with clopidogrel, but this trial showed similar safety endpoints. What do you think are the reasons behind this?
《国际循环》:在TRITON试验中,普拉格雷的出血风险高于氯吡格雷,但是TRITON试验中两组的安全性终点相似。你认为出现这一结果的原因是什么?
Dr. Neumann: Well, if you do not have any difference in efficacy, it is no wonder that there is no difference in safety. Mind you, if you combine the major and minor bleeding events there is this difference that we would expect with a stronger anti platelet drug.
Neumann博士:如果疗效终点没有差异的话,安全性终点也没有差异,这并不奇怪。别忘了,如果将严重出血和轻度出血事件合并分析的话,普拉格雷组和氯吡格雷组是有差异的,更强的抗血小板治疗时是会发生这些情况的。
<International Circulation>:Is it possible that, due to the lower dose of prasugrel, it may be a safer option?
《国际循环》:是否由于普拉格雷剂量更低,它就是更为安全的治疗选择?
Dr. Neumann: But that also maybe a reason for a lack of efficacy. We always have to first look at efficacy. Without it, we do not need to worry about safety. The results for the primary analysis focusing on patients under 75 are very consistent. As far as I can tell, there is not much difference between the primary analysis group and the whole cohort. I do not think the dose reduction in the elderly made a major impact on the study, particularly as the primary analysis focuses on younger patients.
Neumann博士:但这也可能是缺乏疗效的原因。我们总是首先要看疗效。没有疗效的话,我们不需要担忧安全性的问题。针对75岁以下患者的初步分析结果是非常一致的。据我所知,初步分析的患者和整个队列之间并没有很多的差异。我不认为老年患者的剂量减少对试验会有严重影响,尤其是初步分析针对的是较为年轻的患者。
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