[Inhibitors of platelet aggregation in the therapy of arteriosclerosis obliterans]
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Thrombocyte aggregation inhibitors show promise in preventing atherosclerosis and thrombus formation. While theoretical concepts are supported by practice, further research is needed to statistically confirm their prophylactic value.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Hematology
Context:
- Thrombocytes play a central role in atherogenesis and thrombus formation on diseased blood vessel walls.
- Acetylsalicylic acid, dipyridamole, and sulfinpyrazone are suitable thrombocyte aggregation inhibitors for clinical use.
- Primary prevention studies using these inhibitors have been limited, while secondary prevention studies in patients with manifest arteriosclerosis are numerous but ongoing.
Purpose:
- To critically summarize existing literature on thrombocyte aggregation inhibitors in atherosclerosis prevention.
- To review their impact on peripheral angioorganopathies.
- To present preliminary findings from a study on diabetic angiopathy prophylaxis using Micristin.
Summary:
- The theoretical basis for using thrombocyte aggregation inhibitors in preventing atherosclerosis appears to be supported by practical observations.
- Numerous studies have investigated these inhibitors in secondary prevention for patients with established cardiovascular and peripheral diseases.
- While promising, observed successes require further statistical validation, and a definitive conclusion on their prophylactic efficacy is pending.
Impact:
- Provides a critical overview of the current state of knowledge regarding thrombocyte inhibitors in cardiovascular disease prevention.
- Highlights the need for continued research and statistically robust studies to ascertain the definitive prophylactic value of these agents.
- Informs clinical practice and future research directions in the primary and secondary prevention of atherosclerosis and related vascular complications.
Abstract:
The central role of the thrombocytes in the initial atherogenesis and the secondary formation of the thrombus on sclerotically changed walls of the vessels is the basis of all experiments to perform a primary or secondary prevention of the atherosclerosis with thrombocyte aggregation inhibitors. Of the numerous thrombocyte-inhibiting substances acetyl salicylic acid, dipyridamol and sulfinpyrazone proved most suitable for clinical purposes. Apparantly for methodical reasons experiments of a primary prevention of the atherosclerosis with aggregation inhibitors have hitherto not be performed. On the other hand, in numerous quantitatively very different studies on patients with manifest cerebral, coronary and peripheral arteriosclerosis the influencibility of the course of the disease was tested by thrombocyte inhibitors. Since correct prospective studies are connected with enormous organisational expenditure and must extend for a longer period many extensive examinations have not yet finished. In the present survey the hitherto existing reports from literature are critically summarized, taking into particular consideration the per ipheral angioorganopathies and first informations on an own study concerning the prophylaxis of the diabetic angiopathy with Micristin are given. The present state of knowledge allows the conclusion that the well founded theoretical concept is apparantly confirmed by practice. However, the successes observed could be statistically ascertained only in individual cases, so that at present a final estimation of the prophylactic value of these preparations is not yet possible.