<International Circulation>:  One of the things that came up in the group of talks of anti-thrombotic agents was the dose.  Other anti-thrombotics seemed to get by with much smaller doses and some actually saw a better effect with a smaller dose and that maybe the extra anti-platelet effect ended up hurting the patients long-term.  Is the dose you chose for TRACER something that you may reassess in future studies?

   《国际循环》：小组会谈的抗血栓药物的问题之一是剂量。其他抗血栓药物似乎更小的剂量就可以起效，有的居然计量减小 时，疗效更佳。也许是多余的抗血小板作用，最终长期损害患者。你可能在将来重新评估TRACER 研究中选用的剂量吗？
 
    Prof. Mahaffey:  It is something to think about.  The pharmacology of Vorapaxar is that it has a very long half-life and accumulates in the blood stream over time regardless of the dose used.  Whether we can actually modulate the effects of Vorapaxar on the platelet to block the platelet at varying levels still needs some further thought.  Optimum dose is a strategy to be considered.   Another thing we also talked about on the panel was about whether to not use three or four agents at any given time and considering not treating with things like aspirin or thienopyridine.  We also considered studies looking at Vorapaxar and aspirin compared to other strategies.  We need to have some additional thought and reflection on the data we have collected already and see what TAR2P tells us before we are ready to make decisions on the exact pathway to move forward.

    Mahaffey教授：这是需要思考的问题。Vorapaxar药理学表明，它的半衰期狠长，并随着时间推移堆积在血液中，无论何种剂量。实际上我们是否可以在不同的剂量下调节Vorapaxar封闭血小板的效果，需要进一步的研究。需要确定最佳剂量。我们在座谈会上谈到的另一件事是是否在任何时间内都不能同时使用三四种药物，并考虑不用阿司匹林或噻吩并吡啶之类的药物治疗。我们还考虑Vorapaxar和阿司匹林与其他治疗比较的研究。在我们确定好研究的确切方案前，我们需要有一些更多的思考和对我们收集的数据进行反思，看TAR2P能告诉我们什么。

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