<International Circulation>:In what cases would you still use prasugrel?

  《国际循环》：你会在什么情况下仍然使用普拉格雷？
 
    Prof. Wright:  Prasugrel is a great drug.  If you have someone who has been on clopidogrel and has an acute coronary syndrome， or a higher risk patient like a 40-50 year old diabetic having an ST elevation myocardial infarction， I would tend to favor prasugrel to get a little better efficacy.  I might just as easily choose ticagrelor in that population.  Those two drugs， however， have not been compared and you cannot tell if one is better than the other.  Another scenario is if there is a person with increased thrombotic risk and you only want to take a drug once daily instead of twice， prasugrel has an advantage of a once per day agent whereas ticagrelor is twice per day.  

    Wright教授:普拉格雷是一个很棒的药。如果你认识的某个人患有急性冠脉综合征、或一个年龄在40-50岁、合并糖尿病及ST段抬高心肌梗死的高危患者正在服用氯吡格雷，我倾向于疗效更好的普拉格雷。我也可能很轻易地选择替卡格雷治疗此类患者。然而，上述两种药物，从未做过对比，你无法知道它们之间哪一个更好。另一种情况是如果有一个病人血栓的风险增加，你只想每天服用一次药物，而不是两次，普拉格雷有这个优势即一天一次即可，而替卡格雷需一天两次。
 
    <International Circulation>: The reason then that prasugrel will stay around is for its convenience and because it there hasn’t been any definitive demonstration that it is inferior to ticagrelor， is that correct?

   《国际循环》：普拉格雷存在下去的原因是它的便捷性，因为没有任何能证明它比替卡格雷差的明确证据，是这样吗？
 
    Prof. Wright:  You statement is accurate and really reflects what most physicians will find themselves thinking about in a year or two when they start to come to market and have a chance to use them.

    Wright教授: 你所说的是正确的，真实反映了大多数内科医生在未来一到两年内当他们开始进入市场并且有机会应用他们时的思考的东西。

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