Kwas acetylosalicylowy: wczoraj, dziś, jutro

• Authors: Marina Nikołajewna Dołżenko

Title variants

EN

Aspirin: yesterday, today, and tomorrow

• Languages of publication: EN

Abstracts

EN

Clinical utility of aspirin (acetylsalicylic acid, ASA) is one of the more important issues in the primary and secondary prevention of cardiovascular disease. The present paper provides analysis of aspirin history, mechanisms of its antiplatelet activity, and expediency of the use of low- and high-dose aspirin in the groups including patients after myocardial revascularization, and requiring secondary prevention of stroke. Also gender-specific aspirin properties were mentioned, highlighting the especially important role of aspirin in women at the age of >65 years, and its utility in all women, irrespectively of age, and those who are at high risk of cardiovascular disease, including atherosclerosis-related cardiovascular disease. Moreover, the mechanisms of aspirin resistance, characterized by inability of aspirin to prevent thromboembolic complications or inadequate platelet inhibition showed in laboratory results, were mentioned. Prevalence of resistance in aspirin-treated patients is estimated to be between 1 and 68%. Stress was also put on the aspirin safety, associated with prophylaxis of peptic ulcer disease, which can be achieved i.e. by the use of the enteric-coated aspirin. This form of aspirin is associated with lower risk of gastrointestinal mucosae damage and bleeding from the gastrointestinal tract. At the end of the article, the importance of the adherence to therapeutic guidelines of aspirin use, including assessment of variation in aspirin bioavailability associated with improper dosing and altered absorption in the gastrointestinal tract, was stressed.

PL

Zastosowanie kwasu acetylosalicylowego we wspołczesnej praktyce klinicznej jest jednym z podstawowych założeń pierwotnej i wtornej prewencji chorob układu sercowo-naczyniowego. W artykule przeanalizowano historię problemu, mechanizm efektywności przeciwpłytkowej kwasu acetylosalicylowego, celowość zastosowania jego wysokich i niskich dawek, a także wykorzystanie u pacjentow z nadciśnieniem tętniczym, po zabiegach rewaskularyzacji mięśnia sercowego oraz w profilaktyce udaru mozgu. Odniesiono się rownież do właściwości kwasu acetylosalicylowego zależnych od płci, podkreślając szczegolnie istotny wpływ u kobiet w wieku powyżej 65 lat oraz podając zalecenie stosowania u kobiet w każdym wieku, w tym u młodych, z podwyższonym ryzykiem rozwoju chorob układu sercowo-naczyniowego, m.in. Związanych z procesem miażdżycowym. Przeanalizowano także kwestię oporności na kwas acetylosalicylowy, ktora charakteryzuje się zarowno jego niezdolnością do zapobiegania rozwojowi powikłań zakrzepowych, jak i do adekwatnego tłumienia funkcji płytek krwi ocenianego w badaniach laboratoryjnych. Częstość ujawniania oporności na kwas acetylosalicylowy u chorych, ktorzy go stosują, waha się w zakresie 1–68%. Zwrocono uwagę na profilaktykę powikłań stosowania kwasu acetylosalicylowego związanych z rozwojem choroby wrzodowej – możliwe jest np. przyjmowanie postaci dojelitowej leku, ktora nieco zmniejsza ryzyko uszkodzeń śluzowki żołądka i krwotokow żołądkowo-jelitowych. Duże znaczenie ma przestrzeganie zaleceń terapeutycznych dotyczących kwasu acetylosalicylowego, tzn. należy uwzględniać możliwość obniżenia jego biodostępności w wyniku nieprzestrzegania zaleceń terapeutycznych, nieodpowiedniego sposobu dozowania albo zaburzeń jego wchłaniania w przewodzie pokarmowym.

Keywords

EN

aspirin; aspirin resistance; gastroprotection; gastroprotekcja; kwas acetylosalicylowy; oporność na kwas acetylosalicylowy

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Pediatria i Medycyna Rodzinna
• Year: 2014
• Volume: 10
• Issue: 2
• Pages: 137–151

Contributors

author

Marina Nikołajewna Dołżenko

• Oddział Kardiologii, Państwowa Akademia Medyczna Kształcenia Podyplomowego im. P.Ł. Szupika, Kijów, Ukraina

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• Document Type: article