Inhibidores del receptor plaquetario P2Y12. Parte 1 de 2: escenario de acción, farmacología, aplicación clínica y limitaciones de su uso

  • Germán Campuzano-Maya Laboratorio Clínico Hematológico
Palabras clave: activación plaquetaria, agregación plaquetaria, receptores purinérgicos P2Y12, antagonistas del receptor purinérgico P2Y, inhibidores de agregación plaquetaria, ticlopidina, clopidogrel, prasugrel, ticagrelor, cangrelor, elinogrel.

Resumen

Las enfermedades cardiovasculares, incluidas 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. La prevención primaria y secundaria de las enfermedades aterotrombóticas, como el infarto agudo de miocardio, el accidente cerebrovascular y las enfermedades trombóticas, además de las medidas generales para el control de los factores de riesgo tales como la obesidad, el sedentarismo, el tabaquismo, la hipertensión arterial y la diabetes, se han centrado en el control de la agregación plaquetaria. El antiagregante plaquetario por excelencia o universal, sobre todo en la prevención primaria, es la aspirina y la terapia dual con la combinación de aspirina y un inhibidor del receptor plaquetario P2Y12, principalmente el clopidogrel, es usada en la prevención secundaria y en los casos de resistencia a la aspirina. En el momento, se dispone para uso clínico de seis inhibidores del receptor plaquetario P2Y12: la ticlopidina, el clopidogrel, el prasugrel, el ticagrelor, el cangrelor y el elinogrel. En este primer módulo, de dos que serán presentados, se abordará el uso de los inhibidores del receptor plaquetario P2Y12 en la práctica del día a día en la prevención primaria y secundaria de las enfermedades aterotrombóticas, enfocado en el análisis del papel de las plaquetas en la fisiopatología de la enfermedad aterotrombótica y la descripción de los seis inhibidores del receptor plaquetario P2Y12 disponibles ahora y en el futuro. En un segundo módulo se hará una aproximación al concepto de la resistencia a los inhibidores del receptor plaquetario P2Y12, su diagnóstico desde el punto de vista del laboratorio y las diferentes alternativas de manejo cuando se presenta resistencia a uno de estos medicamentos.

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Biografía del autor/a

Germán Campuzano-Maya , Laboratorio Clínico Hematológico

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

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Cómo citar
1.
Germán Campuzano-Maya. Inhibidores del receptor plaquetario P2Y12. Parte 1 de 2: escenario de acción, farmacología, aplicación clínica y limitaciones de su uso. Med. Lab. [Internet]. 1 de enero de 2017 [citado 30 de octubre de 2020];23(1-2):13-4. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/57
Publicado
2017-01-01
Sección
La Clínica y el Laboratorio