Prähospitale Lyse und Akut-PTCA beim akuten Myokardinfarkt mit ST-Hebungen

Zusammenfassung

Der akute Myokardinfarkt mit ST-Hebungen stellt eine der Haupttodesursachen in den westlichen Industriestaaten dar. Das primäre Therapieziel liegt in der raschen Wiedereröffnung des verschlossenen Herzkranzgefäßes. Dies kann entweder durch eine prähospitale Lyse oder eine Akut-PTCA (perkutane transluminale Koronarangioplastie) erreicht werden. Bisherige Studien, die eine prähospitale Lyse mit einer Akut-PTCA verglichen haben, zeigen teilweise uneinheitliche Ergebnisse. Im Rahmen dieser Übersichtsarbeit soll die aktuelle Studienlage beleuchtet werden und auf die geltenden Leitlinien zur Behandlung des akuten Infarktes mit ST-Streckenhebungen eingegangen werden. Zudem werden Wirkmechanismus, Voraussetzungen sowie Kontraindikationen für eine prähospitale Lyse erläutert.

Abstract

Acute ST-elevation myocardial infarctions are one of the major causes for morbidity and mortality in the industrial world. Rapid reopening of the occluded coronary vessel is the major goal in this setting. Prehospital lysis and acute PCI (percutaneous coronary intervention) are two alternatives to obtain this goal. Studies comparing prehospital lysis with acute PCI have shown inconsistent results. This review tries to elucidate current studies and guidelines for the treatment of acute ST-elevation myocardial infarctions. Additionally, mechanisms, indications and contraindications for prehospital lysis are discussed.

Schlüsselwörter

Prähospitale Lyse - ST-Hebungsinfarkt - Akut-PTCA

Key words

Prehospital lysis - ST-elevation myocardial infarction - acute PCI

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