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2017, Número 3

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Rev Clin Esc Med 2017; 7 (3)


Actualidad en el uso de la terapia dual de antiagregación plaquetaria con aspirina y clopidogrel en el manejo agudo de enfermedad cerebrovascular

Sequeira QCM, Villegas RJD

Idioma: Español
Referencias bibliográficas: 30
Paginas: 11-21
Archivo PDF: 272.18 Kb.


RESUMEN

La enfermedad cerebrovascular es una causa líder a nivel mundial de muerte y discapacidad. Un aspecto clave en su abordaje es la prevención secundaria, posterior a la ocurrencia de un ataque isquémico transitorio o un ataque cerebral tipo isquémico. En los pacientes no candidatos a trombolisis, este será el principal abordaje terapéutico a realizar. Las guías tanto nacionales como internacionales incluyen en sus recomendaciones únicamente la monoterapia con aspirina, sin embargo, estudios recientes afirman que la terapia dual con clopidogrel y aspirina iniciadas a las 12 horas posterior a la aparición de síntomas son más efectivas que la medicación única con aspirina y sin aumentar la incidencia de eventos hemorrágicos, valorando a los pacientes a los 90 días y al año postisquemia. Estos beneficios son costo-efectivos. La incorporación generalizada de estos resultados así como la finalización del estudio POINT, podrían representar un cambio en el paradigma terapéutico.


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