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Antiagregantes plaquetarios e inhibidores de la bomba de protones. Cómo optimizar el riesgo-beneficio en los pacientes con riesgo cardiovascular y riesgo de hemorragia gastrointestinal?

par Casado Arroyo, Ruben ;Muñoz-Villalenguas, María;Lanas Arbeloa, Angel
Référence Gastroenterología y hepatología, 34, 7, page (478-491)
Publication Publié, 2011

Article révisé par les pairs

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Résumé :

Antiplatelet agents are routinely used in both primary and secondary prevention of cardiovascular events. The development of new antiplatelet agents and the strong growth of interventional cardiology have led to this therapy being more widely prescribed and for longer periods. The most important secondary effect is the rise in the incidence of hemorrhagic complications, the most prevalent being gastrointestinal bleeding. In this context, the balance between the cardiovascular benefits and bleeding risk of these agents must be optimized. This review provides specific management recommendations and highlights important practical aspects related to antiplatelet therapy, including the interaction between clopidogrel and proton pump inhibitors. The benefits and hazards in distinct clinical settings are outlined within the context of optimizing the balance between the cardiovascular benefits and bleeding risk of antiplatelet therapy.