A terapêutica antitrombótica: atual e em desenvolvimento

Authors

  • Ana Afonso Serviço de Angiologia e Cirurgia Vascular, Hospital Garcia de Orta, Almada, Portugal
  • Gil Marques Serviço de Angiologia e Cirurgia Vascular, Hospital Garcia de Orta, Almada, Portugal
  • Ana Gonçalves Serviço de Angiologia e Cirurgia Vascular, Hospital Garcia de Orta, Almada, Portugal
  • Pedro Barroso Serviço de Angiologia e Cirurgia Vascular, Hospital Garcia de Orta, Almada, Portugal
  • Antonio Gonzalez Serviço de Angiologia e Cirurgia Vascular, Hospital Garcia de Orta, Almada, Portugal
  • Hugo Rodrigues Serviço de Angiologia e Cirurgia Vascular, Hospital Garcia de Orta, Almada, Portugal
  • Maria José Ferreira Serviço de Angiologia e Cirurgia Vascular, Hospital Garcia de Orta, Almada, Portugal

DOI:

https://doi.org/10.48750/acv.3

Keywords:

Anticoalugação, Novos Anticoagulantes Orais, Terapêutica antiagregante, Farmacologia

Abstract

Thrombosis is one of the major causes of death worldwide. Continous increase in the knowledge about the pathophysiological changes associated with thrombosis led to the development of effective therapies (anti-platelet, anticoagulant and fibrinolytics) for the prevention and treatment of the thromboembolic disease.

However, better understanding of the underlying processes is still crucial for the development of more effective and safer antithrombotic drugs.

The aim of this review is summarize the current treatment, as well as the new agentes and to highlight their proven or possible role in Vascular Surgery.

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References

1. Davì G, Patrono C. Platelet activation and atherothrombosis. N
Engl J Med. 2007;357:2482---92.
2. Bhatt DL, Topol EJ. Scientific and therapeutic advances in
antiplatelet therapy. Nat Rev Drug Discov. 2003;2:15---28,
http://dx.doi.org/10.1038/nrd985.
3. Garg VP, Halperin JL. Novel antiplatelet and anticoagulant
agents in the cardiac care unit. Cardiol Clin. 2013;31:533---44.
4. Moog S, Mangin P, Lenain N, et al. Platelet glycoprotein V binds
to collagen and participates in platelet adhesion and agreggation.
Blood. 2011;98:1038---46.
5. Gale AJ. Continuing education course #2: Current understanding
of hemostasis. Toxicol Pathol. 2011;39:273---80.
6. Antiplatelet Trialists’ Collaboration. Collaborative overview of
randomised trials of antiplatelet therapy–I: Prevention of death,
myocardial infarction, and stroke by prolonged antiplatelet therapy
in various categories of patients. BMJ. 1994;308:81---106.
7. Berger JS, Krantz MJ, Kittelson JM, et al. Aspirin for the prevention
of cardiovascular events in patients with peripheral
artery disease: A meta-analysis of randomized trials. JAMA.
2009;301:1909---19.
8. Halawani S, Brittenden J, Bachoo P, et al. Evaluation of Aspirin
Resistance in Peripheral Arterial Disease. J Thromb Haemost.
2005;S1:P1140.
9. Janzon L, Bergqvist D, Boberg J, et al. Prevention of myocardial
infarction and stroke in patients with intermittent claudication;
effects of ticlopidine. Results from STIMS, the Swedish
Ticlopidine Multicentre Study. J Intern Med. 1990;227:301---8.
10. Cadroy Y, Bossavy JP, Thalamas C, et al. Early potent antithrombotic
effect with combined aspirin and a loading dose of
clopidogrel on experimental arterial thrombogenesis in humans.
Circulation. 2000;101:2823---8.
11. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel
versus aspirin in patients at risk of ischaemic events
(CAPRIE). Lancet. 1996;348:1329---39.
12. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus
for the management of peripheral arterial disease (TASC II).
J Vasc Surg. 2007;45 SupplS:S5---67.
13. Rooke TW, Hirsch AT, Misra S, et al. Focused update of the
Guideline for the Management of Patients With Peripheral
Artery Disease (Updating the 2005 Guideline): A Report of the
American College of Cardiology Foundation/American Heart
Association Task Force on Practice Guidelines. J Am Coll Cardiol.
2011;58:2020---45.
14. Tendera M, Aboyans V, Bartelink ML, et al. ESC Guidelines on the
diagnosis and treatment of peripheral artery diseases: Document
covering atherosclerotic disease of extracranial carotid
and vertebral, mesenteric, renal, upper and lower extremity
arteries: the Task Force on the Diagnosis and Treatment of
Peripheral Artery Diseases of the European Society of Cardiology
(ESC). Eur Heart J. 2011;32:2851---906.
15. Alonso-Coello P, Bellmunt S, McGorrian C, et al. Antithrombotic
therapy in peripheral artery disease: Antithrombotic Therapy
and Prevention of Thrombosis, 9th ed: American College
of Chest Physicians Evidence-Based Clinical Practice Guidelines.
Chest. 2012;141 2Suppl:e669S---90S.
16. Bhatt Deepak L, Topol EJ, CHARISMA Executive Committee.
Clopidogrel added to aspirin versus aspirin alone in secondary
prevention and high-risk primary prevention: Rationale and
design of the Clopidogrel for High Atherothrombotic Risk and
Ischemic Stabilization, Management, and Avoidance (CHARISMA)
trial. Am Heart J. 2004;148:263---8.
17. Scheinert D, Schroder M, Ludwig J, et al. Stent-supported
recanalization of chronic iliac occlusions. Am J Med.
2001;110:708---15.
18. Mwipatayi BP, Thomas S, Wong J, et al. A comparison of covered
versus bare expandable stents for the treatment of aortoiliac
occlusive disease. J Vasc Surg. 2011;54:1561---70.
19. Sabeti S, Mlekusch W, Amighi J, et al. Primary patency of long-
-segment self-expanding nitinol stents in the femoropopliteal
arteries. J Endovasc Ther. 2005;12:6---12.
20. Laird JR, Katzen BT, Scheinert DT, et al. Nitinol stent implantation
versus balloon angioplasty for lesions in the superficial
femoral artery and proximal popliteal artery. Twelve-month
results from the RESILIENT randomized trial. Circ Cardiovasc
Interv. 2010;3:267---76.
21. Dake M, Ansel G, Jaff MR, et al. Paclitaxel-eluting stents show
superiority to balloon angioplasty and bare-metal stents in
femoropopliteal disease: Twelve-month Zilver PTX randomized
study results. Circ Cardiovasc Interv. 2011;4:495---504.
22. Werk M, Langner S, Reinkensmeier B, et al. Inhibition of restenosis
in femoropopliteal arteries: Paclitaxel-Coated Versus
Uncoated Balloon: Femoral Paclitaxel Randomized pilot trial.
Circulation. 2008;118:1358---65.
23. Micari A, Cioppa A, Vadalà G, et al. Clinical evaluation of
a paclitaxel-eluting balloon for treatment of femoropopliteal
arterial disease: 12-month results from a multicenter Italian
registry. JACC Cardiovasc Interv. 2012;5:331---8.
24. Eisenstein EL, Anstrom KJ, Kong DF, et al. Clopidogrel use and
long-term clinical outcomes after drug-eluting stent implantation.
JAMA. 2007;297:159---68.
25. Cocheri S. Antiplatelet drugs --- do we need new options?
With a reprpraisal of direct thromboxan inhibitors. Drugs.
2010;70:887---908.
26. Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel
in patients with acute coronary syndromes. N Engl Med.
2009;361:1045---57.
27. Patel MR, Becker RC, Wojdyla DM, et al. Cardiovascular events
in acute coronary syndrome patients with peripheral arterial
disease treated with ticagrelor compared with clopidogrel:
Data from the PLATO Trial. Eur J Prev Cardiol. 2015;22:
734---42.
28. Bonaca MP, Bhatt DL, Cohen M, et al. Long-term use of ticagrelor
in patients with prior myocardial infarction. N Engl J Med.
2015;372:1791---800.
29. Berger JS, Katona BG, Jones WS, et al. Design and rationale
for the effects of ticagrelor and clopidogrel in patients with
peripheral artery disease (EUCLID) Trial. Am Heart J. 2016.
30. Ferreiro JL, Ueno M, Angiolillo DJ. Cangrelor: A review on its
mechanism of action and clinical development. Expert Rev Cardiovasc
Ther. 2009;7:1195---201.
31. Ferreiro JL, Ueno M, Tello-Montoliu A, et al. Effects of cangrelor
in coronary artery disease patients with and without diabetes
mellitus: An in vitro pharmacodynamic investigation. J Thromb
Thrombolysis. 2013;35:155---64.
32. Oestreich JH. Elinogrel, a reversible P2Y12 receptor antagonist
for the treatment of acute coronary syndrome and prevention
of secondary thrombotic events. Curr Opin Investig Drugs.
2010;11:340---8.
33. Komosa A, Lesiak M, Siniawski A, et al. Significance of antiplatelet
therapy in emergency myocardial infarction treatment. Postepy
Kardiol Interwencyjnej. 2014;10:32---9, http://dx.doi.org/
10.5114/pwki.2014.41466.
34. Ferri N, Corsini A, Bellosta S. Pharmacology of the new P2Y12
receptor inhibitors: Insights on pharmacokinetic and pharmacodynamic
properties. Drugs. 2013;73:1681---709.
35. Siller-Matula JM, Krumphuber J, Bernd J. Pharmacokinetic,
pharmacodynamic and clinical profile of novel antiplatelet
drugs targeting vascular diseases. Br J Pharmacol.
2010;159:502---17.
36. Kalantzi KI, Tsoumani ME, Goudevenos IA, et al. Pharmacodynamic
properties of antiplatelet agents: Current knowledge and
future perspectives. Expert Rev Clin Pharmacol. 2012;5:319---36.
37. Stangl PA, Lewis S. Review of currently available GP IIb/IIIa inhibitors
and their role in peripheral vascular interventions. Semin
Intervent Radiol. 2010;27(No. 4). Thieme Medical Publishers.
38. Dörffler-Melly J, Mahler F, Do DD, et al. Adjunctive abciximab
improves patency and functional outcome in endovascular
treatment of femoropopliteal occlusions: Initial experience.
Radiology. 2005;237:1103---9.
39. Ansel GM, Silver MJ, Botti CF Jr, et al. Functional and clinical
outcomes of nitinol stenting with and without abciximab for
complex superficial femoral artery disease: A randomized trial.
Catheter Cardiovasc Interv. 2006;67:288---97.
40. Morrow DA, Scirica BM, Fox KA, et al. Evaluation of a novel
antiplatelet agent for secondary prevention in patients with a
history of atherosclerotic disease: Design and rationale for the
Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic
Ischemic Events (TRA 2 degrees P)-TIMI 50 trial.
Am Heart J. 2009;158:335---41, e3.
41. Bonaca MP, Gutierrez JA, Creager M, et al. Acute Limb Ischemia
and Outcomes With Vorapaxar in Patients With Peripheral
Artery Disease Results From the Trial to Assess the Effects of
Vorapaxar in Preventing Heart Attack and Stroke in Patients
With Atherosclerosis---Thrombolysis in Myocardial Infarction 50
(TRA2◦ P-TIMI 50). Circulation. 2016;133:997---1005.
42. (a) Celestini A, Violi F. A review of picotamide in the reduction
of cardiovascular events in diabetic patients. Vasc Health Risk
Manag. 2007;3:93---8;
(b) Berger JS, Krantz MJ, Kittelson JM, et al. Aspirin for the
prevention of cardiovascular events in patients with peripheral
artery disease: A meta-analysis of randomized trials.
JAMA. 2009;301:1909---19, http://dx.doi.org/10.1001/jama.
2009.623 pmid:19436018. Epub 2009/05/14.
43. Ferreiro JL, Angiolillo DJ. New directions in antiplatelet therapy.
Circ Cardiovasc Interv. 2012;5:433---45.
44. Neri Serneri GG, Coccheri S, Marubini E, et al. Picotamide, a
combined inhibitor of thromboxane A2 synthase and receptor,
reduces 2year mortality in diabetics with peripheral arterial
disease: The DAVID study. Eur Heart J. 2004;25:1845---52.
45. Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary
prevention of cardiovascular events in people with diabetes:
A position statement of the American Diabetes Association, a
scientific statement of the American Heart Association, and an
expert consensus document of the American College of Cardiology
Foundation. Circulation. 2010;121:2694---701, http://dx.
doi.org/10.1161/CIR.0b013e3181e3b133 pmid:20508178. Epub
2010/05/29.
46. Berger JS, Lala A, Krantz MJ, et al. Aspirin for the prevention
of cardiovascular events in patients without clinical
cardiovascular disease: A meta-analysis of randomized trials.
Am Heart J. 2011;162:115---24, http://dx.doi.org/10.1016/
j.ahj.2011.04.006 pmid:21742097, e2. Epub 2011/07/12.
47. Katsanos K, Spiliopoulos S, Saha P, et al. Comparative efficacy
and safety of different antiplatelet agents for prevention
of major cardiovascular events and leg amputations in patients
with peripheral arterial disease: A systematic review and
network meta-analysis. PLoS One. 2015;10.8:e0135692.
48. Silvestre L, Ministro A, Evangelista A, et al. Novos anticoagulantes
orais no tromboembolismo venoso e fibrilhac¸ão auricular.
Ang Cir Vasc. 2012;8:06---11.
49. Eikelboom J, Weitz J. Update on Antithrombotic Therapy - New
Anticoagulants. Circulation. 2010;121:1523---32.
50. Mueck W, Stampfuss J, Kubitza D, et al. Clinical pharmacokinetic
and pharmacodynamic profile of rivaroxaban.
Clin Pharmacokinet. 2014;53:1---16, http://dx.doi.org/10.1007/
s40262-013-0100-7.
51. ClinicalTrials.gov [Internet]. Identifier NCT02504126 Eficacy and
Safety of Rivaroxiban in Reducing the Risk of Major Thrombotic
Vascular Events in Subjects with Peripheral Disease Undergoing
Peripheral Revascularization Procedures of the Lower Extremities
(VOYAGER PAD) [acessado em 9 de marc¸o de 2016]. Disponível
em: https://clinicaltrials.gov/ct2/show/NCT02504216
52. Ordovás Baines JP, Climent Grana E, Jover Botella A,
et al. Pharmacokinetics and pharmacodynamics of the new
oral anticoagulants dabigatran and rivaroxaban. Farm Hosp.
2009;33:125---33.
53. Parasrampuria DA, Marbury T, Matsushima N, et al. Pharmacokinetics,
safety, and tolerability od edoxaban in end-stage renal
disease subjects undergoing hemodialysis. J Thromb Haemost.
2015;113:719---27.
54. Schulman S, Kearon C, Kakkar AK, et al. Dabigatran versus
warfarin in the treatment of acute venous thromboembolism.
N Engl J Med. 2009;361:2342---52.
55. Fonseca C, Alves J, Araújo F. Manuseio peri-operatório dos
doentes medicados com anticoagulantes e anti-agregantes
plaquetário: resultado na 3.a reunião de consenso da Sociedade
Portuguesa de Anestesiologia. Rev Soc Port Anestesiol.
2014;23:76---93.
56. Gogarten W, Vandermeulen E, van Aken H, et al. Regional
anaesthesia and antithrombotic agents: Recommendations of
the European Society of Anaesthesiology. Eur J Anaesthesiol.
2010;27:999---1015.
57. Spyropoulos A, Douketis J. How I treat anticoagulated patients
undergoing an elective procedure or surgery. Blood.
2012;120:2954---62.
58. Lip GYH, Douketis JD. Perioperative management of patients
receiving anticoagulants. UpToDate.com online; 12/2014.
59. Daley BJ, Taylor D, Aycinena Goicolea JF. Perioperative Anticoagulation
Management. eMedicine from WebMD. 2012. Updated
January 17 [acessado em 10 de marc¸o de 2016]. Available at:
http://emedicine.medscape.com/article/285265-overview
60. Schulman S, Kakkar AK, Schellong SM, et al. A randomized trial
of dabigatran versus warfarin in the treatment of acute venous
thromboembolism (RE-COVER II). San Diego, CA: Presented at
the American Society of Hematology Annual Meeting; 2011.
December 10-13.
61. The EINSTEIN Investigators. Oral rivaroxaban for symptomatic
venous thromboembolism. N Engl J Med. 2010;363:2499---510.
62. Agnelli G, Buller HR, Cohen A, et al., AMPLIFY Investigators. Oral
apixaban for the treatment of acute venous thromboembolism.
N Engl J Med. 2013;369:799---808.
63. Büller HR, Décousus H, Grosso MA, et al. Edoxaban versus warfarin
for the treatment of symptomatic venous thromboembolism.
N Engl J Med. 2013;369.15:1406---15.

Published

2016-11-22

How to Cite

1.
Afonso A, Marques G, Gonçalves A, Barroso P, Gonzalez A, Rodrigues H, Ferreira MJ. A terapêutica antitrombótica: atual e em desenvolvimento. Angiol Cir Vasc [Internet]. 2016 Nov. 22 [cited 2024 Mar. 28];12(3):170-9. Available from: https://acvjournal.com/index.php/acv/article/view/3

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Section

Review Article