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Gerinnungsaktive Medikamente zur Sekundärprophylaxe bei pAVK

Bewährte und neue Therapieansätze

Medications affecting coagulation for secondary prophylaxis in PAD – tried and tested treatments and new approaches

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Zusammenfassung

Die periphere arterielle Verschlusserkrankung (pAVK) ist eine Markererkrankung für ein hohes kardiovaskuläres Risiko. Der vorliegende Artikel gibt eine Übersicht über die vorliegenden Daten zur Sekundärprophylaxe kardiovaskulärer Ereignisse mit Thrombozytenaggregationshemmern und Antikoagulanzien. Derzeit sollten Patienten mit pAVK zur Sekundärprävention einmal täglich einen Thrombozytenaggregationshemmer (75 mg. Clopidogrel oder 75–300 mg ASS) erhalten. Eine Kombinationstherapie mehrerer Thrombozytenaggregationshemmern ist für diese Indikation nicht empfehlenswert. Auch die Gabe von VKA oder Heparinen kann nicht empfohlen werden, wenn nicht andere Indikationen zur Antikoagulation (z. B. Vorhofflimmern) vorliegen. Des Weiteren werden in diesem Artikel die Besonderheiten der gerinnungshemmenden Therapie bei Patienten nach peripherer Bypassoperation oder endovaskulärer Therapie diskutiert.

Abstract

Peripheral arterial occlusive disease (PAD) is associated with high cardiovascular risk. This paper reviews the published data on antithrombotic therapy for secondary prophylaxis of cardiovascular events with platelet aggregation inhibitors and anticoagulants. Patients with PAD should receive a platelet aggregation inhibitor (75 mg clopidogrel or 75–300 mg Aspirin) once daily. A combination treatment with several different platelet aggregation inhibitors is not recommended for this purpose. The administration of vitamin K antagonists or heparins also cannot be recommended, unless other conditions (e.g. atrial fibrillation) are present for which anticoagulation is indicated. The paper also deals with antithrombotic therapy for patients who have undergone peripheral bypass surgery and endovascular procedures.

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Interessenkonflikt

Der korrespondierende Autor weist auf eine Verbindung mit folgender Firma/Firmen hin: Vortragshonorare der Firmen Sa██ti-Arentes, Roche, Gloxo-Smth-█, Novartis.

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  1. Medizinische Klinik I (Kardiologie/Angiologie), Universitätsklinik Gießen und Marburg, Standort Gießen, Klinikstr. 36, 35385 , Gießen, Deutschland

    M. Grebe

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  1. M. Grebe
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Correspondence to M. Grebe.

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Grebe, M. Gerinnungsaktive Medikamente zur Sekundärprophylaxe bei pAVK. Gefässchirurgie 11, 341–346 (2006). https://doi.org/10.1007/s00772-006-0484-x

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  • DOI: https://doi.org/10.1007/s00772-006-0484-x

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