ASS in der Primär- und Sekundärprävention kardiovaskulärer Erkrankungen

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

Publikationsverlauf

Artikel online veröffentlicht:
08. Dezember 2020

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