Antikoagulanzien oder Aggregationshemmer

F. Störkel; H. Klepzig; I. Scharrer

doi:10.1055/s-0038-1660318

Hämostaseologie, Table of Contents

Hamostaseologie 1992; 12(02): 068-072
DOI: 10.1055/s-0038-1660318

Übersichtsarbeit/Review Articles

Schattauer GmbH

Antikoagulanzien oder Aggregationshemmer

während und nach Thrombolyse und nach PTCA zur Prophylaxe der Reokklusion

F. Störkel

¹Zentrum der Inneren Medizin, Universitätskliniken Frankfurt

^*Abteilung für Angiologie (Leiter: Prof. Dr. H. K. Breddin)

,

H. Klepzig

¹Zentrum der Inneren Medizin, Universitätskliniken Frankfurt

^**Abteilung für Kardiologie (Leiter: Prof. Dr. M. Kaltenbach)

,

I. Scharrer

¹Zentrum der Inneren Medizin, Universitätskliniken Frankfurt

^*Abteilung für Angiologie (Leiter: Prof. Dr. H. K. Breddin)

› Author Affiliations

Abstract

Zusammenfassung

Die thrombolytische Therapie ist das Mittel der Wahl zur Behandlung des akuten Myokardinfarktes. Mit welchen Medikamenten lassen sich aber die nach einem Herzinfarkt erfolgreich wiedereröffneten Koronargefäße offen halten und spätere Reinfarkte verhindern? In einer großen prospektiven Studie konnte der positive Effekt von ASS in Kombination mit thrombolytischer Therapie auf die frühe Mortalität nach Herzinfarkt gezeigt werden. Weiterführende Studien erbrachten, daß eine Kombination von ASS und Heparin, letzteres 24 Stunden bis zu 7 Tage nach Infarkt und thrombolytischer Therapie, ein bestmöglicher Schutz vor einem Reverschluß darstellt. In der Sekundärprävention nach Myokardinfarkt ist ASS in Dosen von 160-300 mg/d als Langzeitprophylaxe wirksam, wie verschiedene Studienergebnisse zeigen. Orale Antikoagulanzien werden vor allem bei Patienten mit Herzwandthrombus eingesetzt. Nach PTCA verhindert ASS den akuten Reverschluß. Längerfristig läßt sich die Restenosierung des dilatierten Gefäßes jedoch nicht verhindern.

Schlüsselwörter

Myokardinfarkt - Thrombolyse - ASS - Heparin

Keywords

Myocardial infarction - thrombolysis - aspirin - heparin

Full Text

References

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