Antiaggregant therapy

Czech version

Authors: J. Malý; M. Pecka; P. Ďulíček; M. Blažek; L. Smolej
Authors‘ workplace: II. interní klinika Lékařské fakulty UK a FN, Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc.
Published in: Vnitř Lék 2005; 91(7 a 8): 826-832
Category: 128th Internal Medicine Day - 21rd Vanysek's Day Brno 2005

Overview

Antiaggregant treatment is suitable for all at risk patients with atherothrombosis and its cardiovascular complications. Antiaggregant treatment decreases severe vascular events in at risk patients, myocardial infarctions, non-fatal strokes, transient ischaemic attacks, unstable angina, obstructive peripheral vascular disease. It decreases a risk of embolism caused by atrial fibrillation and a risk of vascular occlusion in other patients at high risk. Antiaggregant treatment should be administered long-term. The basic antiaggregant drug is acetylsalicylic acid (ASA) which is commonly used in doses of 75–150 mg daily. Acetylsalicylic acid is an effective antiaggregant drug with clearly demonstrated beneficial effect on atherothrombotic complications in cardiovascular diseases. Other substances and drugs with antiaggregant effect including their modes of action and indications are reviewed.

Keywords:
cardiovascular diseases – antiaggregant therapy

Sources

1. Andersson LO, Borrowcliffe TW, Holmer E et al. Molecular weight dependency of the heparin potentiated inhibition of thrombin and activated factor X. Effect of heparin neutralization in plasma. Thromb Res 1979; 115: 531–541.

2. Antithrombotics Trialist’s Collaboration. Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction and stroke in high risk patiens. BMJ 1999; 318: 759–764.

3. Awtry HA, Loscalzo J. Aspirin. Circulation 2000; 101: 1206–1218.

4. Badimon L, Badimon JJ. Interaction of platelet activation and coagulation. In Fuster V, Topol EJ (Eds.) Atherosklerosis and coronary artery disease. Philadelphia: Lippincott – Raven Publishers 1996: 639–656.

5. Bultas J, Karetová D. Léčba trombotických stavů – kde jsme a kam se ubíráme. Remedia 2004; 14: 182–200.

6. Dalen JE. An apple a day or an aspirin a day. Arch Intern Med 1991; 151: 1066–1069.

7. Gum PA, Kottke Marchant K, Poggio ED et al. Profile and prevalence of aspirin resistance in patients with cardiovascular disease. Am J Cardiol 2001; 88: 230–235.

8. Harrington RA, Becker RC, Ezekowitz Met al. Antithrombotic Therapy for Coronary Artery Disease: The 7^th ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126: 513S–548S.

9. Hirmerová J, Filipovský J. Klinický význam aspirinové rezistence. Vnitř Lék 2004; 50: 462–469.

10. Karetová D, Bultas J. Rezistence na aspirin – laboratorní odchylka nebo klinický problém. Interní medicína pro praxi 2005; 1: 10–13.

11. Kottke-Marchant K, Corcoran G. The Laboratory Diagnosis of Platelet Disorders. Arch Pathol Lab Med 2001; 126: 133–146.

12. Kurth T, Glynn RJ, Walker AM et al. Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal intiinflamatory drugs. Circulation 2003; 108: 1191–1195.

13. Malý J. Vyšetření aktivity destičkových funkcí se vztahem k rezistenci na kyselinu acetylsalicylovou. Vnitř Lék 2005; 51(2): 157–162.

14. Maree AO, Fitzgerald DJ. Aspirin and coronary artery disease. Thromb Haemost 2004; 92: 1175–1181.

15. McKee SA, Sane DC, Dellargyris EN. Aspirin resistance in cardiovascular diseases: A review of prevalence, mechanisms and clinical significance. Thromb Haemost 2002; 88: 711–715.

16. Patrono C, Coller B, FitzGerald GA et al. Platelet-Active Drugs: The Relationships Among Dose, Effectiveness, and Side Effects: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126: 234S–264S.

17. Popma JJ, Berger P, Ohman EM et al. Antithrombotic Therapy During Percutaneous Coronary Intervention: The 7^th ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126: 576S–599S.

18. Patrono C, Bachmann F, Baigent C et al. European Society of Cardiology Expert consensus document on the use of antiplatelet agents. The task force on the use of antiplatelet agents in patients with atherosclerotic cardiovascular disease of the European society of cardiology. Eur Heart J 2004; 25: 166–181.

19. Patrono C, Coller B, Dalen JE et al. Platelet – Active Drugs. The relationship among dose, effectiveness and side effects. Chest 2001; 119: 39–63.

20. Pecka M. Laboratorní hematologie v přehledu. Fyziologie a patofyziologie hemostázy. Český Těšín: FINIDR 2004.

21. Samama MM, Elalamy I. Aspirine et hémostase. Rev Méd Interne 2000; 21(Suppl 1): 27–34.

22. Vane JR, Bakhle YS, Botting RM. Cyklooxygenases 1 a 2. Ann Rev Pharmacol Toxicol 1998; 38: 97–120.

23. Vojáček J. Inhibitory destičkových glykoproteinových receptorů typu Iib/IIIa. Remedia 2003; 13: 84–92.

24. Vojáček J, Malý M, Hraboš V et al. Hladina tkáňového faktoru, inhibitoru tkáňového faktoru a solubilního P–selektinu u nemocných s akutním koronárním syndromem. Cor Vasa 2002; 44: 148–151.