dostęp otwarty

Tom 15, Nr 3 (2018)
Farmakoterapia chorób układu krążenia
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Klopidogrel po zabiegach stentowania tętnic obwodowych oraz u chorych z miażdżycą tętnic obwodowych. Dowody, zalecenia i praktyka

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

dostęp otwarty

Tom 15, Nr 3 (2018)
Farmakoterapia chorób układu krążenia

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.

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.
Pobierz cytowanie

Słowa kluczowe

choroba tętnic obwodowych, leki przeciwpłytkowe, kwas acetylosalicylowy, klopidogrel, podwójna terapia przeciwpłytkowa, stentowanie naczyń obwodowych

Informacje o artykule
Tytuł

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

Czasopismo

Choroby Serca i Naczyń

Numer

Tom 15, Nr 3 (2018)

Strony

146-158

Rekord bibliograficzny

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

Słowa kluczowe

choroba tętnic obwodowych
leki przeciwpłytkowe
kwas acetylosalicylowy
klopidogrel
podwójna terapia przeciwpłytkowa
stentowanie naczyń obwodowych

Autorzy

Grzegorz Halena

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