Inhibidores del receptor plaquetario P2Y12. Parte 2 de 2: etiología, diagnóstico y manejo de la resistencia

  • Germán Campuzano-Maya Universidad de Antioquia
Palabras clave: antagonistas del receptor purinérgico P2Y, inhibidores de agregación plaquetaria, resistencia a medicamentos.

Resumen

Las enfermedades cardiovasculares, que comprenden las afecciones del corazón, del cerebro y de los vasos sanguíneos en general, representan la primera causa de muerte a nivel mundial con diecisiete millones y medio de muertes cada año, de los cuales una tercera parte se debe a eventos trombóticos. La antiagregación plaquetaria con diferentes agentes, incluidos los inhibidores del receptor plaquetario P2Y12, se ha convertido en la piedra angular de la prevención primaria y secundaria y del tratamiento de las enfermedades cardiovasculares, entre ellas el infarto agudo de miocardio, la apoplejía y las enfermedades trombóticas. Sin embargo, varios estudios de investigación han demostrado que algunos individuos presentan disminución en la respuesta in vivo a estas sustancias, la cual se expresa como resistencia. En el primer módulo se abordó el papel de las plaquetas en la enfermedad aterotrombótica y se describieron los seis inhibidores del receptor plaquetario P2Y12, disponibles para su uso clínico actual o a futuro: la ticlopidina, el clopidogrel, el prasugrel, el ticagrelor, el cangrelor y el elinogrel. En este segundo módulo se tratará el concepto de la resistencia a los inhibidores del receptor plaquetario P2Y12, en particular al clopidogrel, la etiología de la resistencia y el monitoreo de la antiagregación con inhibidores del receptor plaquetario P2Y12 mediante pruebas de función plaquetaria, como una manera de hacer una antiagregación personalizada; finalmente, se darán las pautas básicas para el manejo de la resistencia a los inhibidores del receptor plaquetario P2Y12.

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Biografía del autor/a

Germán Campuzano-Maya , Universidad de Antioquia

Médico, especialista en Hematología y Patología Clínica. Docente Ad Honorem, Facultad de Medicina, Universidad de Antioquia. Coordinador Grupo de Investigación en Patología Clínica. Médico Director, Laboratorio Clínico Hematológico. Medellín, Colombia.

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Cómo citar
1.
Campuzano-Maya G. Inhibidores del receptor plaquetario P2Y12. Parte 2 de 2: etiología, diagnóstico y manejo de la resistencia. Med. Lab. [Internet]. 1 de marzo de 2017 [citado 22 de abril de 2021];23(3-4):313-48. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/47
Publicado
2017-03-01
Sección
La Clínica y el Laboratorio

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