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[Inhibition of blood platelet function].

Blood platelets play a decisive role in haemostasis and thrombosis. Besides the known approaches for preventing thrombosis by inhibition of the plasmatic coagulation, it seems promising to prevent thrombus formation, particularly in the arterial vasculature, by pharmacological control of platelet functions. Drugs with antiaggregating effects are described from the clinico-pharmacological point of view. Non-steroidal antiphlogistics - especially acetylsalicylic acid - several vasodilators, alpha- and beta-adrenergic receptor blockers, as well as some others have been used therapeutically. To test these drugs for the prophylaxis of thrombosis, long-term prospective clinical trials are necessary.

Adrenergic alpha-Antagonists↗

Guidelines for the management of transient ischemic attacks.

On the basis of a review of the literature on anticoagulant, antiplatelet, and surgical treatment, supplemented by our personal experience, we have developed guidelines for the management of patients with transient ischemic attacks (TIA). 1. The majority of patients with vertebral-basilar TIA are treated medically. 2. If a skilled surgeon and an experienced angiographer are available, patients with typical carotid TIA who are suitable medical risks should have angiography followed by carotid endarterectomy if an appropriate lesion is found. 3. Nonoperated patients with TIA of less than 2 months' duration are treated with 3 months of warfarin therapy (unless contraindicated) before treatment with aspirin is begun. 4. Nonoperated patients with continuing TIA of 2 or more months' duration are treated with aspirin unless there has been a recent increase in the frequency, duration, or severity of TIA. Under these circumstances, warfarin therapy is advised for 3 months before aspirin is started. Aspirin therapy should be continued until the patient has been free of TIA for 1 year. 5. No treatment is advised for nonoperated patients whose last episode of TIA was longer than 12 months ago.

Anticoagulants↗

Platelet aggregation and atherosclerosis.

The relationship of platelet aggregation to coronary and cerebral ischemic attacks has been well established. A number of clinical trials have shown that the daily use of aspirin 160 to 325 mg daily, dipyridamole 300 to 400 mg daily, or both are effective in preventing platelet aggregation, and results in a statistically significantly reduction in the incidence of coronary events and transient ischemic cerebral attacks.

Arteriosclerosis↗