Antiaggregation treatment and drug coated stents in 2007

Česká verzia

Authors: J. Špinar ¹; J. Vítovec ²
Authors place of work: Interní kardiologická klinika LF MU a FN Brno pracoviště Bohunice ¹; I. interní kardioangiologická klinika LF MU a FN U svaté Anny, Brno ²
Published in the journal: Kardiol Rev Int Med 2007, 9(4): 247-250
Category: Editorial

Summary

Antiaggregation treatment and drug coated stents in 2007. Antiaggregation treatment is the basis for therapy after surgical intervention, especially in the coronary system, with or without stent implant. The results of the CHARISMA study raised a certain amount of caution. The study monitored patients with proven cardiovascular disease (secondary prevention) or with a high cardiovascular risk (primary prevention). The addition of clopidogrel to standard treatment by acetylsalicylic acid (ASA) did not improve the prognosis. The occurrence of the primary objective – the 1st myocardial infarction, cerebrovascular event and cardiovascular death – was similar in both the groups, and the only decrease recorded was from 7.9 % to 6.9 % (p – 0.046) in the secondary prevention primary objective. The entire year 2006 was marked by the discussion about the safety of coated stents (DES) and about the necessary length of antiaggregation therapy after their implantation. In early 2007, registers from different countries occurred pointing to higher rates of thromboses and deaths in patients with DES. The explanation for this surprising finding is linked with premature discontinuation of dual antiaggregation (ASA + clopidogrel). We provide the official stand of the European Society of Cardiology, American Heart Association and the Ministry of Health of the Czech Republic concerning antiaggregation treatment in 2007.

Keywords:
ASA – clopidogrel – mortality – bleeding – thrombosis

Zdroje

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