Τόμος 9 (1991) – Τεύχος 1 – Άρθρο 5 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση – Volume 9 (1991) – Issue 1 – Article 5 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

9: 31-44 (1991)

PHARMAKON-Press: Epitheorese Klin. Farmakol. Farmakokinet.

9: 31-44 (1991)

antiplatelet drugs, ticlopidine, ischemic heart disease prosthetic cardiac valves, pacing

Platelet thrombosis and blood coagulation are two distinctive although inter­related procedures, the one enhancing the other. According to local conditions one of the two mechanisms usually predominates. Thera­peutic management is different in each case. In unstable angina, platelet-thrombus formation is the main contributing mechanism and combi­ned administration of heparin and aspirin or ticlopidine is recommended. In acute myocar­dial infarction the same treatment is recom­mended in addition to thrombolytic treatment. In the postinfarction period anti-platelet treat­ment is recommended in order to avoid relapse due to thrombotic events. In case of chronic stable angina the same treatment is believed to diminish the possibility of myocardial infarction, although the evolution of the atheromatic disease is not stopped. Ticlopidine is probably more active. The treatment with aspirin, di­pyridamole or ticlopidine reduces the develop­ment of acute thrombotic obstructions after PTCA. Treatment with dipyridamole can be started before the placement of aortocoronary vein grafts and antiplatelet therapy has to be continued for at least one year with aspirin or ticlopidine. In case of acute myocardial infarction affecting the whole anterior wall, classic anticoagulation treatment (heparin – coumarin derivatives) is indicated for at least three months. Chronic aneurysms are not_. usually embologenic. Dilated cardiomyopathy, cardiac failure and highly embologenic atrial fibrilla­tion demand treatment with coumarin deriva­tives. Mechanical valve prostheses demand chronic treatment with coumarin derivatives plus dipyridamole. Anticoagulation treatment is given during the first trimester after placement of biological prostheses. In other conditions treatment is still under consideration.

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