Odjel za kardijalnu kirurgiju pridržava se slijedećih smjernica u provođenju antiagregacijske terapije prije i nakon operacijskog zahvata:

 

PRIJE OPERACIJSKOG ZAHVATA

  • terapiju ASK (Andol, Aspirin, Aspirin protect) potrebno prekinuti 3-5 dana prije elektivne operacije

  • terapiju klopidrogelom (Plavix, Pigrel, Zyllt) potrebno prekinuti 5-7 dana prije elektivne operacije

 

NAKON OPERACIJSKOG ZAHVATA

  • potrebno uvesti antiagregacijsku terapiju 6h nakon zahvata ili po isključenju krvarenja
    ASK je lijek izbora (150 mg/dan trajno)

  • u slučaju preosjetljivosti ili nuspojava (GI sustav!) na ASK zamjena je klopidrogel (300 mg inicijalno, doza održavanja 75 mg/dan)


Literatura:

1. The Society of Thoracic Surgeons Practice Guideline Series: Aspirin and Other Anti-Platelet Agents during Operative Coronary Revascularization. A Report from The Society of Thoracic Surgeons Workforce on Evidence-Based Medicine; 2003.

2. CASCADE randomized controlled trial: clopidogrel and aspirin versus aspirin alone after coronary bypass surgery Alexander Kulik, Michel Le May, George A Wells et al.; 2005.

3. Comparative benefits of clopidogrel and aspirin in high-risk patient populations: lessons from the CAPRIE and CURE studies. Long-term graft patency
Hirsh J, Bhatt DL: Arch Intern Med 2004.

4. Effects of aspirin:3 years after coronary artery surgery. Results of a VA Cooperative study. Kern KB, Sethi G, Sharma GV, Khuri S, et al.: Circulation 1994.

5. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Eagle KA, Guyton RA, Davidoff R et al.: Circulation 2004.


  
 
web administrator: Davor Barić   web design: Ana Berc   datum posljednjeg obnavljanja: 03.01.2007