Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tulane University, New Orleans, LA, USA.
Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, USA.
Drugs. 2015 Sep;75(14):1613-25. doi: 10.1007/s40265-015-0455-1.
Antiplatelet agents remain the cornerstone in the primary and secondary therapeutic intervention for cardiovascular disease. Some patients may be subjected to a year or more of dual antiplatelet therapy to reduce the risk of subsequent cardiovascular events. Patients on antiplatelet therapy have an increased risk of gastrointestinal bleeding; however, not all patients benefit from concomitant acid suppressive therapy. This review will provide an overview of the pharmacology of antiplatelet agents and outline patient risk profiles that ought to be considered when considering prophylactic therapy to reduce gastrointestinal toxicity. In addition, we discuss the current risk-reduction strategies intended to mitigate against the potential for related gastroduodenal injury.
抗血小板药物仍然是心血管疾病一级和二级治疗干预的基石。一些患者可能需要接受一年或更长时间的双联抗血小板治疗,以降低随后发生心血管事件的风险。接受抗血小板治疗的患者发生胃肠道出血的风险增加;然而,并非所有患者都能从联合酸抑制治疗中获益。本综述将概述抗血小板药物的药理学,并概述在考虑预防性治疗以降低胃肠道毒性时应考虑的患者风险特征。此外,我们还讨论了旨在减轻潜在胃十二指肠损伤风险的当前降低风险策略。