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Titolo:
Current oral antiplatelet agents to prevent atherothrombosis
Autore:
Hankey, GJ;
Indirizzi:
Royal Perth Hosp, Dept Neurol, Stroke Unit, Perth, WA 6001, Australia Royal Perth Hosp Perth WA Australia 6001 Unit, Perth, WA 6001, Australia
Titolo Testata:
CEREBROVASCULAR DISEASES
, volume: 11, anno: 2001, supplemento:, 2
pagine: 11 - 17
SICI:
1015-9770(2001)11:<11:COAATP>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOMIZED CONTROLLED TRIALS; CORONARY STENT IMPLANTATION; HIGH-RISK PATIENTS; SECONDARY PREVENTION; ACETYLSALICYLIC-ACID; CEREBRAL-ISCHEMIA; ARTERIAL ORIGIN; ASPIRIN; TICLOPIDINE; THERAPY;
Keywords:
antiplatelet agents; stroke;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Hankey, GJ Royal Perth Hosp, Dept Neurol, Stroke Unit, Wellington St, Perth, WA 6001,Australia Royal Perth Hosp Wellington St Perth WA Australia 6001ustralia
Citazione:
G.J. Hankey, "Current oral antiplatelet agents to prevent atherothrombosis", CEREB DIS, 11, 2001, pp. 11-17

Abstract

Aspirin inhibits platelet activation by irreversibly inhibiting platelet cyclooxygenase and thromboxane production, and reduces the odds of serious vascular events (stroke, myocardial infarction or vascular death) by about one quarter in a range of patients with symptomatic atherosclerosis at high risk of a subsequent event. The adenosine diphosphate (ADP) receptor antagonists clopidogrel and ticlopidine are significantly more effective than aspirin in high-risk vascular patients, further reducing the odds of serious vascular events by about 10% (95% CI 2-19%) over the benefit provided by aspirin. The ADP receptor antagonists are also associated with a significant 30% reduction in the odds of gastrointestinal haemorrhage (odds ratio 0.71, 95% CI 0.59-0.86). Ticlopidine increases the odds of skin rash and of diarrhoea by more than twofold compared with aspirin, whereas clopidogrel is associated with a one-third increase in the odds of rash and of diarrhoea. Only ticlopidine increases the odds of neutropenia compared with aspirin. There is no clear evidence as yet for the benefit of dipyridamole or an oral GPIlb/llla receptor antagonist as single anti-platelet agents in atherothrombotic patients. Amongst high vascular risk patients, the combination of low-dose aspirin and high-dose dipyridamole is associated with about a 10% (95% CI 0-20%) reduction in the odds of a serious vascular event. Most of thisreduction is due to a 23% reduction in non-fatal stroke. The size of this estimate continues to be investigated in an ongoing study of patients with transient ischaemic attack and stroke. The combined use of aspirin and ticlopidine is markedly superior to heparin, warfarin and aspirin for reducing thrombotic complications after coronary artery stenting. Clopidogrel plus aspirin has been shown to be safer than aspirin and ticlopidine in coronary stenting, and is now under long-term evaluation in unstable angina, and other conditions in which patients are at high risk of atherothrombotic events. Copyright (C) 2001 S. Karger AG, Basel.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 15:52:53