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Colegio de Medicina Interna de México.

2023, Número 3

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Med Int Mex 2023; 39 (3)


Terapia antiplaquetaria dual: “La evidencia de lo evidente”

Muñoz-Rossi FA, Ricardo-Ossio GP, Orozco-Molina PA, Puentes-Rodríguez CJ, Camargo-Vargas DA

Idioma: Español
Referencias bibliográficas: 40
Paginas: 495-503
Archivo PDF: 219.85 Kb.


RESUMEN

Es claro el papel contundente de la terapia antiplaquetaria dual en la reducción de eventos cardiovasculares adversos mayores recurrentes en los pacientes con síndrome coronario agudo y crónico, con tendencia cada vez menor en la administración de esta terapia en duración y tiempo óptimo recientemente demostrado en el escenario de pretratamiento del síndrome coronario, generando controversia en el papel actual dado por las guías ESC 2020, basado en un perfil de riesgo y estrategia de gestión de acuerdo con el riesgo de hemorragia, a su vez, como el cambio de paradigma en la terapia antitrombótica con la inclusión de los anticoagulantes orales directos en el escenario de terapia extendida. Debemos recordar la indicación de la terapia antiplaquetaria dual/anticoagulación oral en síndrome coronario agudo y fibrilación auricular, la recomendación de duración cada vez más corta de la triple terapia, con la elección adecuada de antiagregante de acuerdo con el riesgo del paciente. No menos importantes son los avances recientes en la administración de la terapia antiplaquetaria dual en pacientes con ataque cerebrovascular con papel cada vez más relevante en el escenario transitorio o leve (NIHSS 3), esto ante la evidencia de estudios como el CHANCE y el POINT. Este artículo tiene el objetivo de proporcionar una revisión de la evidencia actual de la terapia antiplaquetaria dual y su utilidad en distintos escenarios en prevención secundaria.


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