Interní Med. 2008; 10(2): 69-73

Contemporary antiplatelet treatment in clinical practice

doc. MUDr. Jiří Špác CSc
II. interní klinika FN u sv. Anny LF MU, Brno

Antiplatelet treatment remains one of the basic preventive therapeutic measures in treatment of atherosclerosis complications and must be accompanied by all other therapeutic measures. The goal of further research is to make the treatment even more effective with fewer side effects. Acetylsalicylic acid remains a basic antiplatelet medication that decreases the incidence of serious vascular events in patients with symptomatic atherosclerosis by 25 %. ADP receptor antagonists – clopidogrel and ticlopidin-are more effective in decrease of risk of vascular events by another 10 % with an increase of cost of treatment. A combination of acetylsalicylic acid with ADP receptor antagonists is significantly more effective in prevention of thrombotic complications than individual drugs alone, especially important is the combination treatment in interventions and after acute coronary syndromes. So far we do not know how to use the combination in the treatment of acute cerebrovascular events because of increased risk of bleeding and it is less effective than anticoagulation treatment in prevention of cardioembolism in atrial fibrillation. New medications combining properties of antiplatelet and anticoagulation treatment are intensively being developed.

Keywords: primary and secondary prevention of ischemic heart disease, antithrombotics

Published: May 1, 2008  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Špác J. Contemporary antiplatelet treatment in clinical practice. Interní Med. 2008;10(2):69-73.
Download citation

References

  1. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324: 71-86. Go to original source... Go to PubMed...
  2. Bhatt DL, Fox KA, Hacke W, et al. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354: 1706-1717. Go to original source... Go to PubMed...
  3. Bulpitt Ch. J. Secondary prevention of coronary heart disease in the elderly. Heart 2005; 91: 396-400. Go to original source... Go to PubMed...
  4. CAPRIE steering committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996; 348: 1329-1339. Go to original source... Go to PubMed...
  5. Clappers N, Brouwer MA, Verheugt FWA. Antiplatelet treatment for coronary heart disease. Heart 2007; 93: 258-265. Go to original source... Go to PubMed...
  6. Collet JP, Montalescot G, Blanchet B, et al. Impact of prior use or recent withdrawal of oral antiplatelet agents on acute coronary syndromes. Circulation 2004; 110: 2361-2367. Go to original source... Go to PubMed...
  7. Dalen JE. Aspirin to prevent heart attack and stroke: What's the right dose? The American Journal of Medicine 2006; 119: 198-202. Go to original source... Go to PubMed...
  8. Ferrari E, Benhamou M, Cerboni P, Baudouy M. Coronary syndromes following aspirin withdrawal. A special risk for late stent thrombosis. J Am Coll Cardiol., 2005; 45 (3): 456-459. Go to original source... Go to PubMed...
  9. Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary prevention of cardiovascular events: A summary of the evidence for the US preventive services task force. Ann Intern Med 2002; 136: 161-172. Go to original source... Go to PubMed...
  10. Joner M, Finn A, Farb A, Erik K, Mont, Frank D. Kolodgie, Ladich, E. Kutys, R. Skorija, K., Herman K. Gold, and Renu Virmani: Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 2006; 48: 193-202. Go to original source... Go to PubMed...
  11. Lim MJ, Spencer FA, Gore JM, Dabbous OH, Agnelli G, Kline-Rogers EM, DiBenedetto D, Eagle KA, Mehta RH. Impact of combined pharmacologic treatment with clopidogrel and a statin on outcomes of patients with non-ST-segment elevation acute coronary syndromes: perspectives from a large multinational registry. European Heart Journal, 2005; 26 (11): 1063-1069. Go to original source... Go to PubMed...
  12. Lutsep HL. MATCH Results: Implications for the internist. The American Journal of Medicine, 2006; 119: 526. Go to original source... Go to PubMed...
  13. Malý J, Pecka M, Dulíček P, Blažek M, Smolej L. Protidestičková léčba. Vnitř Lék 2005; 51 (7&8): 826-832.
  14. Matetzky S, Shenkman B, Guetta V, et al. Clopidogrel resistance is associated with increased risk of recurrent atherothrombotic events in patients with acute myocardial infarction. Circulation 2004; 109: 3171-3175. Go to original source... Go to PubMed...
  15. Patrono C, Bachmann F, Baigent C, Bode C, De Caterina R, Charbonnier B, Fitzgerald D, Hirsh J, Husted S, Kvasnicka J, Montalescot G, García Rodríguez LA, Verheugt F, Vermylen J, Wallentin L) Antiplatelet agents (Expert Consensus Document on the Use of Antiplatelets Agent. European Heart Journal, 2004; 25 (2): 166-181. Go to original source... Go to PubMed...
  16. Penka M, Gumulec J. Principy antitrombotické léčby. Kardiologická revue, 2004; 4: 142-150.
  17. Sacco RL, Adams R, Albers G, Alberts MJ, Benavente O, Furie K, Goldstein LB, Gorelick P, Halperin J, Harbaugh R, Johnston SC, Katzan I, Kelly-Hayes M, Kenton EJ, Marks M, Schwamm LH, Tomsick T. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/ American Stroke Association council on stroke: cosponsored by the council on cardiovascular radiology and intervention: the American Academy of Neurology affirms the value of this guideline. Stroke. 2006; 37: 577-617. Go to original source... Go to PubMed...
  18. Souček M, Vítovec J. Studie EVA (EValuation of Atherothrombosis). Farmakoterapie, 2005; 4: 394.
  19. Špác J, Hlinomaz O. Možnosti dlouhodobé antiagregační léčby na počátku 21. století. Kardiofórum, 2006; 4 (1): 1-9.
  20. Špinar J, Hradec J, Meluzín J, Špác J, Špinarová L, Vítovec J, Lupínek P, Málek I. Doporučení pro diagnostiku a léčbu chronického srdečního selhávání ČKS 2006. Cor Vasa, 2007; 49 (1): Kardio K5-K34.




Internal Medicine for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.