Kwas acetylosalicylowy – rola w zapobieganiu chorobom układu sercowo-naczyniowego i ich leczeniu Artykuł przeglądowy
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Opublikowane:
kwi 13, 2010
Słowa kluczowe:
kwas acetylosalicylowy, leczenie przeciwpłytkowe, choroby układu sercowo-naczyniowego
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Abstrakt
Kwas acetylosalicylowy jako lek przeciwpłytkowy jest stosowany od ponad 50 lat. Działanie antyagregacyjne aspiryny polega na nieodwracalnym blokowaniu cyklooksygenazy płytkowej, kluczowego enzymu na szlaku przemian prostaglandyn. Blokowanie cyklooksygenazy prowadzi do utraty zdolności syntezy tromboksanu A2, najsilniejszej substancji naczynioobkurczającej i stymulującej agregację płytek. Kwas acetylosalicylowy poprzez działanie przeciwpłytkowe zmniejsza ryzyko wystąpienia chorób układu sercowo-naczyniowego. Nadal prowadzone są badania nad antyagregacyjnym działaniem kwasu acetylosalicylowego. Wyniki dużych badań epidemiologicznych oraz metaanaliz wskazują na znamienne statystycznie zmniejszenie ryzyka wystąpienia incydentów zakrzepowo-zatorowych u pacjentów przyjmujących kwas acetylosalicylowy. Istotny problem towarzyszący leczeniu przeciwpłytkowemu stanowi aspirynooporność. Konieczne jest wypracowanie jednolitych metod pozwalających na identyfikację pacjentów z aspirynoopornością w celu podjęcia skutecznego leczenia antyagregacyjnego.
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Jak cytować
Gierlak, W., & Kuch , M. (2010). Kwas acetylosalicylowy – rola w zapobieganiu chorobom układu sercowo-naczyniowego i ich leczeniu . Medycyna Faktów , 3(1(6), 78-87. Pobrano z https://journalsmededu.pl/index.php/jebm/article/view/2618
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Bibliografia
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13. Eidelman R.S., Hebert P.R., Weisman S.M. et al.: An update on aspirin in the primary prevention of cardiovascular disease. Arch. Intern. Med. 2003; 163: 2006-2010.
14. Lauer M.S.: Aspirin for primary prevention of coronary events. N. Engl. J. Med. 2002; 346: 1468-1474.
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19. Berger J.S., Rancaglioni M.C., Avanzini F. et al.: Aspiryn for the primary prevention of cardiovascular events In women and men: a sex-specific metaanalysis of randomized controlled trails. JAMA 2006 Jan 18; 295(3): 306-13.
20. Zimmermann N. et al.: Aspirin resistance after coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg. 2001; 121: 982-4.
21. Teal P.A. et al.: Recent clinical trial results with antiplatelet theraphy: implication in stroke prevention. Cerebrovasc. Dis. 2004; 17(supl. 3): 6-10.
22. The ESPRIT study group. Aspirin plus dipiridamol versus aspirin alone after cerebral ischaemia of arterial origin. Lancet 2006; 367: 1665-1673.
23. van Latum J.C., Koudstaal P.J., Venables G.S., van Gijn J., Kappelle L.J., Algra A. (for the European Atrial Fibrillation Trial (EAFT) Study Group): Predictors of Major Vascular Events in Patients With a Transient Ischemic Attack or Minor Ischemic Stroke and With Nonrheumatic Atrial Fibrillation. Stroke 1995; 5(26): 801-6.
24. Stroke Prevention in Atrial Fibrillation investigators: Warfarin versus aspirin for prevention of tromboembolism in Atrial Fibrillation II study. Lancet 1994; 343: 687.
25. Fuster V. et al.: Management of atrial fibrillation. Eur. Heart J. 2001; 22: 1852-1923.
26. The ACTIVE investigators: Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N. Engl. J. Med. 2009 May 14; 360(20): 2066-78.
27. Howard P.A.: Aspirin resistance. Ann. Pharmacother. 2002; 36: 1620-4.
28. The HOPE Study Investigators. The HOPE (Heart Outcomes Prevention Evaluation) Study: The design of a large, simple randomized trial of an angiotensin converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events. Can. J. Cardiol. 1996; 12: 127-137.
29. Welsh P.A. et al.: A prospective, blinded determination of the natural history of aspiryn resistance among stable patients with cardiovascular disease. J. Am. Coll. Cardiol. 2003; 41: 961-5.
30. Cambria-Kiely J.A., Gandhi P.J.: Possible mechanisms of aspiryn resistance. J. Thromb. Thrombolysis 2002; 13: 49-56.
31. Cambria-Kiely J.A., Gandhi P.J.: Aspiryn resistance and genetic polymorphisms. J. Thromb. Thrombolysis 2002; 14: 51-8.
32. Verstuyft C.: Personalized Medicine and Antiplatelet Therapy: Ready for Prime Time? European Heart Journal 2009; 30(16): 1943-1963.
33. Gasparyan A.Y. et al.: The Role of Aspirin in Cardiovascular Prevention. JACC 2008; 51(19): 1829-1843.
2. Cannon C.P. et al.: Current use of aspirin and antithrombotic agents in the United States among outpatients with atherothrombotic disease (from the Reduction of Atherothrombosis for Continued Health [REACH] Registry). Am. J. Cardiol. 2010; 105: 445-452.
3. Patrono C.: Aspirin as an antiplateled drug. N. Engl. J. Med. 1994; 330: 1287.
4. ISIS-2 Collaborative Group: Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 1998; 349: II.
5. The RISC Group: Risc of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease. Lancet 1990; 336: 827.
6. Juul-Moller S. et al.: Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. The Swedish Angina Pectoris Aspirin Trial (SAPAT) Study Investigators. Lancet 1992; 340(8833): 145-153.
7. Antiplateled Tralists Collaboration. Collaborative overview of randomised trias of antiplateled theraphy. Br. Med. J. 1994, 308, 81.
8. Hirs J.: Aspirin and other plateled-active drugs. The relationship between dose, effectiveness and side effects. Chest 1992; 102(supl.): 327.
9. Effects of Clopidogrel in Addition to Aspirin in Patients with Acute Coronary Syndromes without ST-segment Elevation. The Clopidogrel in Unstable Angina to Prevent Recurrent Events ( CURE) Trial Investigators. N. Engl. J. Med. 2001; 345: 494-502.
10. Steering Committee of the Physicians Health Study Research Group: Final report on aspirin component of ongoing Physicians Health Study. N. Engl. J. Med. 1989; 321: 129.
11. Kurth T. et al.: Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal anti-inflamatory drugs. Circulation 2003; 108: 1191.
12. Peto R., Gray R., Collins R. et al.: Randomised trial of profilactic daily aspirin in British male doctors (British Doctor’s Trial). Br. Med. J. 1988 Jan 30; 296(6618): 313-6.
13. Eidelman R.S., Hebert P.R., Weisman S.M. et al.: An update on aspirin in the primary prevention of cardiovascular disease. Arch. Intern. Med. 2003; 163: 2006-2010.
14. Lauer M.S.: Aspirin for primary prevention of coronary events. N. Engl. J. Med. 2002; 346: 1468-1474.
15. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. EHJ 2007; 28: 2375-2414.
16. American Diabetes Association: Standards of medical care in diabetes – 2006. Diabetes Care 2006; 29(supl. 1): S4-S42.
17. American Diabetes Association. Standards of medical care in diabetes – 2010. Diabetes Care 2010; 33(supl. 1).
18. Ridker P.M., Cook N.R., Lee J.M. et al.: A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women (Women’s Health Study). N. Engl. J. Med. 2005 Mar 7; 352: 1293-1304.
19. Berger J.S., Rancaglioni M.C., Avanzini F. et al.: Aspiryn for the primary prevention of cardiovascular events In women and men: a sex-specific metaanalysis of randomized controlled trails. JAMA 2006 Jan 18; 295(3): 306-13.
20. Zimmermann N. et al.: Aspirin resistance after coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg. 2001; 121: 982-4.
21. Teal P.A. et al.: Recent clinical trial results with antiplatelet theraphy: implication in stroke prevention. Cerebrovasc. Dis. 2004; 17(supl. 3): 6-10.
22. The ESPRIT study group. Aspirin plus dipiridamol versus aspirin alone after cerebral ischaemia of arterial origin. Lancet 2006; 367: 1665-1673.
23. van Latum J.C., Koudstaal P.J., Venables G.S., van Gijn J., Kappelle L.J., Algra A. (for the European Atrial Fibrillation Trial (EAFT) Study Group): Predictors of Major Vascular Events in Patients With a Transient Ischemic Attack or Minor Ischemic Stroke and With Nonrheumatic Atrial Fibrillation. Stroke 1995; 5(26): 801-6.
24. Stroke Prevention in Atrial Fibrillation investigators: Warfarin versus aspirin for prevention of tromboembolism in Atrial Fibrillation II study. Lancet 1994; 343: 687.
25. Fuster V. et al.: Management of atrial fibrillation. Eur. Heart J. 2001; 22: 1852-1923.
26. The ACTIVE investigators: Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N. Engl. J. Med. 2009 May 14; 360(20): 2066-78.
27. Howard P.A.: Aspirin resistance. Ann. Pharmacother. 2002; 36: 1620-4.
28. The HOPE Study Investigators. The HOPE (Heart Outcomes Prevention Evaluation) Study: The design of a large, simple randomized trial of an angiotensin converting enzyme inhibitor (ramipril) and vitamin E in patients at high risk of cardiovascular events. Can. J. Cardiol. 1996; 12: 127-137.
29. Welsh P.A. et al.: A prospective, blinded determination of the natural history of aspiryn resistance among stable patients with cardiovascular disease. J. Am. Coll. Cardiol. 2003; 41: 961-5.
30. Cambria-Kiely J.A., Gandhi P.J.: Possible mechanisms of aspiryn resistance. J. Thromb. Thrombolysis 2002; 13: 49-56.
31. Cambria-Kiely J.A., Gandhi P.J.: Aspiryn resistance and genetic polymorphisms. J. Thromb. Thrombolysis 2002; 14: 51-8.
32. Verstuyft C.: Personalized Medicine and Antiplatelet Therapy: Ready for Prime Time? European Heart Journal 2009; 30(16): 1943-1963.
33. Gasparyan A.Y. et al.: The Role of Aspirin in Cardiovascular Prevention. JACC 2008; 51(19): 1829-1843.