Via practica S3/2010

Contemporary antiplatelet treatment in clinical practice

Antiplatelet treatment remains one of the basic preventive therapeutic measures in treatment of atherosclerosis complications and must be accompanied by all other therapeutic measures. The goal of further research is to make the treatment even more effective with fewer side effects. Acetylsalicylic acid remains a basic antiplatelet medication that decreases the incidence of serious vascular events in patients with symptomatic atherosclerosis by 25 %. ADP receptor antagonists – clopidogrel and ticlopidin – are more effective in decrease of risk of vascular events by another 10 % with an increase of cost of treatment. A combination of acetylsalicylic acid with ADP receptor antagonists is significantly more effective in prevention of thrombotic complications than individual drugs alone, especially important is the combination treatment in interventions and after acute coronary syndromes. So far we do not know how to use the combination in the treatment of acute cerebrovascular events because of increased risk of bleeding and it is less effective than anticoagulation treatment in prevention of cardioembolism in atrial fibrillation. New medications combining properties of antiplatelet and anticoagulation treatment are intensively being developed.

Keywords: primary and secondary prevention of ischemic heart disease, antithrombotics