Neue Thrombozytenaggregationshemmung bei Patienten mit akutem Koronarsyndrom – Umbruch einer langjährigen antithrombozytären Praxis

Die antithrombozytäre Therapie stellt einen Eckpfeiler in der Sekundärprophylaxe bei Patienten nach akutem Koronarsyndrom dar. Die langjährige Praxis der festen Kombination aus Acetylsalicylsäure und Clopidogrel steht vor einem Umbruch – neue antithrombozytäre Medikamente wie Ticagrelor und Prasugrel sind zugelassen und haben aufgrund nachgewiesener Überlegenheit gegenüber Clopidogrel Einzug in die Leitlinien gefunden. Weitere Wirkstoffe sind in der klinischen Erprobung. Der nachfolgende Artikel soll einen Überblick über Wirkung und Nebenwirkungen, pharmakokinetische Eigenschaften sowie aktuelle Entwicklungen im Bereich der pharmakologischen Forschung der Thrombozyteninhibierung liefern.

Antiplatelet therapy is a milestone of secondary prevention after myocardial infarction since the introduction of acetylsalicylic acid. Several years ago this monotherapy was supplemented by thienopyridine. However, modern antiplatelet drugs like Prasugrel or Ticagrelor have been shown to be superior in comparison to Clopidogrel and are therefore now included in the current guidelines. In addition, further developments are underway and will be available in the next years. This article summarizes the (side-) effects of the new drugs and provides an outlook on upcoming therapeutical options.

Key words

Myocardial infarction - secondary prophylaxis - antiplatelet therapy

• Literatur

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