Thrombozytenaggregationshemmung

Die Revaskularisation bei einer koronaren Herzerkrankung mittels perkutaner koronarer Intervention (PCI) kann bei koronarer Herzkrankheit die Lebensqualität und Prognose verbessern. Die verschiedenen Präparate, Kombinationsmöglichkeiten und Dauer der Thrombozytenaggregationshemmung verlangen dabei eine fundierte Abwägung. Folgend wird der aktuelle Stand der Wissenschaft inklusive der neuen Leitlinie zum akuten Koronarsyndrom 2024 dargestellt.

Schlüsselwörter

Revaskularisation - Thrombozytenaggregationshemmung - koronare Herzerkrankung - koronarer Intervention - PCI - Koronarsyndrom - akut - chronisch

• Literatur

• 1 WHO. The top 10 causes of death. 2024 Accessed January 08, 2025 at: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
• 2 Bruthans J, Cífková R, Lánská V. et al. Explaining the decline in coronary heart disease mortality in the Czech Republic between 1985 and 2007. Eur J Prev Cardiol 2014; 21: 829-839
• 3 Rajkumar CA, Foley MJ, Ahmed-Jushuf F. et al. A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina. N Engl J Med 2023; 389: 2319-2330
• 4 Nakazawa G. Stent thrombosis of drug eluting stent: pathological perspective. J Cardiol 2011; 58: 84-91
• 5 Ullrich H, Münzel T, Gori T. Coronary Stent Thrombosis- Predictors and Prevention. Dtsch Arztebl Int 2020; 117: 320-326
• 6 Palmerini T, Kirtane AJ, Serruys PW. et al. Stent thrombosis with everolimus-eluting stents: meta-analysis of comparative randomized controlled trials. Circ Cardiovasc Interv 2012; 5: 357-364
• 7 Pelliccia F, Zimarino M, Niccoli G. et al. In-stent restenosis after percutaneous coronary intervention: emerging knowledge on biological pathways. Eur Hear J Open 2023; 3
• 8 Garcia-Garcia HM, McFadden EP, Farb A. et al. Standardized end point definitions for coronary intervention trials: The academic research consortium-2 consensus document. Circulation 2018; 137: 2635-2650
• 9 Cook KA, White AA. Rapid Aspirin Challenge in Patients with Aspirin Allergy and Acute Coronary Syndromes. Curr Allergy Asthma Rep 2016; 16: 11
• 10 Byrne RA, Rossello X, Coughlan JJ. et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2023; 44: 3720-3826
• 11 Mehran R, Baber U, Sharma SK. et al. Ticagrelor with or without Aspirin in High-Risk Patients after PCI. N Engl J Med 2019; 381: 2032-2042
• 12 Kim HS, Kang J, Hwang D. et al. Prasugrel-based de-escalation of dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (HOST-REDUCE-POLYTECH-ACS): an open-label, multicentre, non-inferiority randomised trial. Lancet 2020; 396: 1079-1089
• 13 Angiolillo DJ, Rollini F, Storey RF. et al. International Expert Consensus on Switching Platelet P2Y12 Receptor-Inhibiting Therapies. Circulation 2017; 136: 1955-1975
• 14 Gragnano F, Cao D, Pirondini L. et al. P2Y12 Inhibitor or Aspirin Monotherapy for Secondary Prevention of Coronary Events. J Am Coll Cardiol 2023; 82: 89-105
• 15 Vrints C, Andreotti F, Koskinas KC. et al. 2024 ESC Guidelines for the management of chronic coronary syndromes: Developed by the task force for the management of chronic coronary syndromes of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2024; 45: 3415-3537
• 16 Gibson CM, Mehran R, Bode C. et al. Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. N Engl J Med 2016; 375: 2423-2434
• 17 Cannon CP, Bhatt DL, Oldgren J. et al. Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation. N Engl J Med 2017; 377: 1513-1524
• 18 Vranckx P, Valgimigli M, Eckardt L. et al. Edoxaban-based versus vitamin K antagonist-based antithrombotic regimen after successful coronary stenting in patients with atrial fibrillation (ENTRUST-AF PCI): a randomised, open-label, phase 3b trial. Lancet 2019; 394: 1335-1343
• 19 Lopes RD, Heizer G, Aronson R. et al. Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation. N Engl J Med 2019; 380: 1509-1524
• 20 Gajanana D, Rogers T, Iantorno M. et al. Antiplatelet and anticoagulation regimen in patients with mechanical valve undergoing PCI – State-of-the-art review. Int J Cardiol 2018; 264: 39-44