Aktuelle Aspekte und Strategien zum Einsatz oraler Antikoagulantien und Plättchenfunktionshemmer in der Praxis

Zusammenfassung

Aufgrund erhöhter venöser und arterieller Risiken und Begleiterkrankungen bei entzündlich-rheumatischen Erkrankungen sind die Grundprinzipien der adäquaten medikamentösen Behandlung auch von Bedeutung in der rheumatologischen Praxis. Bei der oralen Antikoagulation haben die innovativen Nicht-Vitamin K-abhängigen oralen Antikoagulanzien (NOAK) die „klassischen“ Antikoagulanzien, die Vitamin K-Antagonisten (VKA), in vielen Indikationen weitgehend verdrängt; allerdings finden sich weiterhin Gründe, Patienten anstelle von NOAK mit VKA zu antikoagulieren. Bei der medikamentösen Hemmung der Plättchenfunktion werden neben ASS die Thienopyridine Clopidogrel und Prasugrel sowie Ticagrelor eingesetzt; von besonderer Bedeutung ist eine duale Plättchenfunktionshemmung (DAPT) mit Kombination verschiedener Plättchenhemmer. In dieser Übersichtsarbeit wird auf wichtige Aspekte der oralen Antikoagulation und der oralen Plättchenfunktionshemmung eingegangen.

Abstract

As patients with inflammatory rheumatic diseases have increased venous and arterial risks as well as concomitant diseases, the principles of antithrombotic treatment are of major relevance for rheumatologists. In many indications for oral anticoagulation, innovative non-vitamin K-dependent oral anticoagulants (NOAC) have widely replaced vitamin K antagonists (VKA), the traditional anticoagulants. However, there are still some clinical settings in which VKA should be used exclusively or preferentially for anticoagulation. Oral platelet inhibition may be achieved by ASS, thienopyridines (clopidogrel and prasugrel) and ticagrelor; dual antiplatelet treatment (DAPT) with a combination of ASS and other antiplatelet agents is of major importance. This review focuses on some important aspects of oral anticoagulation and oral inhibition of platelet function.

Schlüsselwörter

orale Antikoagulanzien - Vitamin K-Antagonisten (VKA) - Nicht-Vitamin Kabhängige orale Antikoagulanzien (NOAK) - Plättchenfunktionshemmer

Key words

oral anticoagulants - vitamin K antagonists (VKA) - antiplatelet agents - non-vitamin K-dependent oral anticoagulants (NOAC)online publiziert 2022

Publication History

Article published online:
25 July 2022

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