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Titolo:
Value of antiplatelet therapy in preventing thrombotic events in generalized vascular disease
Autore:
Montalescot, G;
Indirizzi:
CHU Pitie Salpetriere, Serv Cardiol, Intens Cardiol Care Unit, F-75013 Paris, France CHU Pitie Salpetriere Paris France F-75013 e Unit, F-75013 Paris, France
Titolo Testata:
CLINICAL CARDIOLOGY
fascicolo: 11, volume: 23, anno: 2000, supplemento:, 6
pagine: 18 - 22
SICI:
0160-9289(200011)23:11<18:VOATIP>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY STENT IMPLANTATION; TICLOPIDINE ASPIRIN STROKE; HIGH-RISK PATIENTS; MYOCARDIAL-INFARCTION; RANDOMIZED TRIAL; RECURRENT STROKE; CLOPIDOGREL; ANTICOAGULATION; DIPYRIDAMOLE; PLACEMENT;
Keywords:
acute coronary syndromes; stroke; myocardial infarction; peripheral artery disease; antiplatelet agents; clinical trials; vascular disease;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Montalescot, G CHU Pitie Salpetriere, Serv Cardiol, Intens Cardiol Care Unit, 47 Blvd Hop, F-75013 Paris, France CHU Pitie Salpetriere 47 Blvd Hop Paris France F-75013 nce
Citazione:
G. Montalescot, "Value of antiplatelet therapy in preventing thrombotic events in generalized vascular disease", CLIN CARD, 23(11), 2000, pp. 18-22

Abstract

Atherothrombosis is the major underlying cause of acute coronary syndromes, ischemic stroke, and peripheral artery disease, and thus is the leading cause of death and disability in Western countries. Platelet inhibitors playa major role in preventing these ischemic complications. There is strong evidence from the Antiplatelet Trialists' Collaboration meta-analysis that aspirin reduces the combined risk of stroke, myocardial infarction (MI), or vascular death in atherosclerotic patients. The Ticlopidine Aspirin Stroke Study (TASS) compared aspirin and ticlopidine in the secondary prevention of high-risk patients after ischemic stroke and demonstrated a significant advantage for ticlopidine over aspirin. In peripheral arterial disease, the Swedish Ticlopidine Multicentre Study (STIMS) showed that ticlopidine was very effective against placebo. Intravenous antiplatelet agents, such as abciximab, tirofiban, and eptifibitide were also proven effective in acute coronary syndromes and unstable angina. In the Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events (CAPRIE) trial, clopidogrel was compared with aspirin in patients with symptomatic atherothrombosis regardless of the initial localization of the ischemic event (coronary, cerebral, or peripheral). The efficacy of clopidogrel based on the first occurrence of ischemic stroke, MI, or vascular death showed a relative risk reduction of 8.7% over and above the 25% reduction currently accepted with aspirin (p < 0.05). The greatest benefit of clopidogrel was in the reduction of fatal and nonfatal MI in the most severe groups of patients, providing a 19% relative risk reduction (p = 0.008). The recent disappointing results obtained with oral glycoprotein IIb/IIIa receptor blocking agents may emphasize the need for other antiplatelet combination therapy, such as aspirin-clopidogrel, in coronary disease, stents, stroke, and possibly atherothrombosis in high-riskpatients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 04:27:51