Stellenwert der ASS-Therapie in der kardio- und zerebrovaskulären Prävention

Zusammenfassung

Acetylsalicylsäure (ASS), eines der am meisten verwendeten Medikamente weltweit, spielt als Thrombozytenaggregationshemmer eine bedeutende Rolle bei der Behandlung und Sekundärprophylaxe vieler vaskulärer Erkrankungen. Dagegen ist die primärprophylaktische Indikation umstritten. Nach der neuesten Evidenz wird der Einsatz von ASS zunehmend kritisch bei Patienten ohne bestehende atherosklerotische Erkrankungen bewertet. Zwar senkt die Substanz die ischämischen Ereignisse, dies geht allerdings mit einem erhöhten Blutungsrisiko einher, sodass in der Summe kein relevanter klinischer Vorteil übrigbleibt. Deswegen wird das Mittel bei Patienten ohne nachgewiesene kardio- bzw. zerebrovaskuläre Erkrankung generell nicht empfohlen.

Abstract

Acetylsalicylic acid (aspirin) is one of the most used medications worldwide. The antithrombotic agent acts mainly through inhibition of cyclooxygenase-1 and consequently thromboxane A₂ synthesis, causing an irreversible suppression of platelet function. Despite of its proven benefit in the treatment and secondary prevention of atherosclerotic diseases, its use for the primary prevention remains controversial due to an unclear balance between the benefits and risks of aspirin. Moreover, the recent evidence indicates that the risk of major bleeding outweighs the potential to reduce ischemic events in patients without atherosclerotic diseases, thus, precluding the general use of aspirin for the primary prevention.

Schlüsselwörter

Acetylsalicylsäure - Prävention - Atherosklerose

Key words

acetylsalicylic acid - prevention - atherosklerosis

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