Neues in der Schlaganfallprävention

Zusammenfassung

Der Schlaganfall ist die häufigste zu dauerhafter Behinderung führende Erkrankung. Neben der effektiven Diagnose und Therapie der Risikofaktoren im Rahmen der Primär-und Sekundärprävention kommt der Gabe von Thrombozytenfunktionshemmern (TFH) zur Sekundärprävention des Schlaganfalls eine wesentliche Bedeutung zu. Neben der Azetylsalizylsäure (ASS) stehen als weitere Substanzen Clopidogrel und die Kombination aus ASS und Dipyridamol zur Verfügung. In der folgenden Übersicht soll die Differenzialtherapie mit den unterschiedlichen Thrombozytenfunktionshemmern dargestellt werden. Ausführlicher wird dabei insbesondere auf mögliche Therapieoptionen bei komplexeren Konstellationen wie z. B. dem persistierenden offenen Foramen ovale oder intrakraniellen Stenosen eingegangen sowie mögliche Indikationen für eine Kombinationstherapie von ASS mit anderen TFH dargestellt.

Summary

In industrialized countries, stroke is a leading cause of death. Of those patients that survive a stroke, many will have to cope with long-term disability. In addition to the effective diagnosis and therapy of known cardiovascular risk factors for primary and secondary prevention strategies, platelet inhibitors are important for the secondary prevention of stroke. Apart from aspirin, the platelet inhibitors clopidogrel and the combination of aspirin and dipyridamole are available. In the following paper we present an overview on the current status of modern differential therapy with the different platelet inhibitors. Possible therapeutic strategies in more complex clinical constellations such as the persistent foramen ovale, intracranial stenosis were described in more detail and possible indications for the combined application of platelet inhibitors are discussed.

Schlüsselwörter

Hirninfarkt - Prävention - Thrombozytenfunktionshemmer - Differenzialtherapie

Keywords

Stroke - prevention - antiplatelet drugs - differential therapy

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