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Kardiologie up2date 2020; 16(04): 315-328
DOI: 10.1055/a-0917-8604
Thrombozyten und Gerinnungssystem bei kardiovaskulären Erkrankungen

ASS in der Primär- und Sekundärprävention kardiovaskulärer Erkrankungen

Alexander Hach
,
Reinhard Sauter
,
Harald Langer
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Der Thrombozytenaggregationshemmer Acetylsalicylsäure (ASS) ist das Medikament der Wahl in der Sekundärprophylaxe zahlreicher kardiovaskulärer Erkrankungen [1]. Hingegen ist die Relevanz von ASS in der Primärprophylaxe nicht umfassend geklärt. Dieser Review beschäftigt sich mit den Therapieoptionen von ASS in der Primär- und Sekundärprävention.
Kernaussagen

  • ASS wirkt als Thrombozytenaggregationshemmer.

  • Große randomisierte Studien wie ASCEND, ARRIVE und ASPREE haben die Wirksamkeit und Sicherheit von ASS in der Primärprävention untersucht.

  • Die Risiken, Blutungen zu erleiden, überwiegen den potenziellen Nutzen von ASS in der Primärprävention.

  • Nur nach sorgfältiger Nutzen-Risiko-Abwägung kommen einzelne Patienten für eine primärprophylaktische ASS-Therapie infrage. Kriterien hierfür sind: Diabetes mellitus, 10-Jahres-Risiko für kardiovaskuläre Ereignisse > 10%, keine Statintherapie sowie niedriges Risiko für gastrointestinale Blutungen.

  • ASS 100 mg/d ist bei kardiovaskulären Hochrisikopatienten im Rahmen der Sekundärprävention indiziert und kann als Standard der Thrombozyten-hemmenden Therapie bezeichnet werden.

Schlüsselwörter

ASS - Thrombozytenaggregation - Primärprävention - Sekundärprävention - KHK


Publication History

Article published online:
08 December 2020

© 2020. Thieme. All rights reserved.

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