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Tom 15, Nr 3 (2018)
Farmakoterapia chorób układu krążenia
Opublikowany online: 2018-12-11

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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Klopidogrel po zabiegach stentowania tętnic obwodowych oraz u chorych z miażdżycą tętnic obwodowych. Dowody, zalecenia i praktyka

Grzegorz Halena1
Choroby Serca i Naczyń 2018;15(3):146-158.

Streszczenie

Podstawą leczenia pacjentów z miażdżycą tętnic są leki przeciwpłytkowe, wśród których od lat dominują kwas acetylosalicylowy i klopidogrel. Ich działanie jest szczególnie dobrze udokumentowane u pacjentów poddanych przezskórnej angioplastyce tętnic wieńcowych. W praktyce chirurga naczyniowego łączenie obu wspomnianych leków przeciwpłytkowych jest częstą strategią mającą zmniejszyć liczbę zakrzepic w stencie wszczepionym do naczynia obwodowego oraz obniżyć częstość incydentów sercowo-naczyniowych w tej grupie chorych. Liczba badań i dowodów w dziedzinie chirurgii naczyniowej jest mniejsza niż liczba analogicznych badań w kardiologii interwencyjnej. Często dokonuje się ekstrapolacji wyników badań leków przeciwpłytkowych na tętnicach wieńcowych na tętnice pozawieńcowe. W ostatnich latach pojawiły się nowe leki przeciwpłytkowe o działaniu silniejszym niż klopidogrel, które często stanowią leki pierwszego rzutu u chorych poddanych stentowaniu tętnic wieńcowych. Artykuł jest próbą podsumowania aktualnej wiedzy na temat stosowania leków przeciwpłytkowych u chorych z miażdżycą tętnic obwodowych, w szczególności u pacjentów poddanych zabiegom stentowania tych tętnic.

Słowa kluczowe: choroba tętnic obwodowychleki przeciwpłytkowekwas acetylosalicylowyklopidogrelpodwójna terapia przeciwpłytkowastentowanie naczyń obwodowych

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