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DOI: 10.1055/s-0037-1616887
Plättchenhemmer aus kardiologischer Sicht
Evidenzbasierte Therapie und neue Ansätze beim akuten Koronarsyndrom ohne ST-StreckenhebungPlatelet inhibitors from a cardiological viewpointEvidence based therapy and new concepts for the acute coronary syndrome without ST-segment elevationPublication History
Publication Date:
27 December 2017 (online)
Zusammenfassung
Die Grundlage des akuten Koronarsyndroms ist die instabile Plaque, an der es zur Adhärenz aktivierter Thrombozyten kommt. Daher steht die Hemmung der Plättchenfunktion ganz im Vordergrund bei der Behandlung des akuten Koronarsyndroms. Gerade auf diesem Gebiet hat es in den vergangenen Jahren große Fortschritte gegeben, was sich in ständig neu aufgelegten Therapieleitlinien widerspiegelt. Neben geänderten Dosierungen und Therapiestrategien sind substanzielle Fortschritte einzelner pharmakologischer Wirkstoffe, auch mit völlig neuen Prinzipien zu verzeichnen. Mehrere Neuentwicklungen befinden sich in der klinischen Testphase. Darüber hinaus treten durch die Erfahrung mit den herkömmlichen Substanzen auch Schwächen dieser Pharmaka (z. B. Resistenzen) zu Tage. Diese Arbeit gibt einen kurzen Überblick über einige, wichtige Aspekte und Neuentwicklungen auf dem Gebiet der Plättchenhemmer aus kardiologischer Sicht.
Summary
The pathophysiology of the acute coronary syndrome is related to a vulnerable, inflammatory plaque promoting activation and aggregation of platelets. Therefore, the inhibition of platelet function is a primary goal of the treatment of the acute coronary syndrome. In recent years this field has made substantial progress, which is reflected by frequently updated treatment guidelines. New dose regimens and therapeutic strategies, but also innovative pharmacological principles evolved recently. Some of these novel drugs are currently tested in clinical trials. Increasing experience with the currently used platelet inhibitors also revealed potential shortcomings of these substances, such as drug resistance. This review will give a cardiological perspective of some important clinical aspects and new developments in the field of platelet inhibitors.
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