Chronisches Koronarsyndrom – optimale medikamentöse Therapie

Zusammenfassung

Der Begriff „chronisches Koronarsyndrom“ ersetzt mit den aktuellen Leitlinien der Europäischen Gesellschaft für Kardiologie (ESC) die Begrifflichkeit der sogenannten „stabilen koronaren Herzerkrankung (KHK)“. Hierdurch werden insbesondere die chronisch-progredienten Eigenschaften der KHK betont. Die medikamentöse Therapie des chronischen Koronarsyndroms zielt auf die Minimierung der Ereignisraten und Symptomprogredienz ab. Zu den wesentlichen Säulen dieser medikamentösen Therapie zählen die Antianginosa (u. a. Betablocker, Kalziumantagonisten, organische Nitrate), die verschiedenen Plättchenaggregationsregime, Lipidsenker sowie Modulatoren des Renin-Angiotensin-Aldosteron-Systems. Eine sogenannte allgemeingültige „optimale Therapie“ ist schwierig zu definieren, daher gilt es, individuell für jeden Patienten die bestmögliche Therapie und Symptomkontrolle anhand dieser Leitlinienempfehlungen zu definieren und nach Bedarf anzupassen.

Abstract

“Chronic coronary syndromes” replaces the term of the so-called “stable coronary artery disease (CAD)” with the current guideline recommendations of the European Society of Cardiology (ESC). This emphasizes the chronic-progressive nature of CAD. The drug therapy for chronic coronary syndromes aims at minimizing event rates and symptom progression/optimal symptom control. The main pillars of these drug therapies include anti-angina therapy (e.g. beta-blockers, calcium antagonists, organic nitrates), the various platelet aggregation regimens, statins, and modulators of the renin-angiotensin-aldosterone system. A so-called, generally valid “optimal therapy” is difficult to define, therefore it is necessary to define the best possible therapy and symptom control for each patient on the basis of these guidelines and to adapt it as required.

Was ist wichtig?

• Der Begriff „chronisches Koronarsyndrom“ ersetzt erstmals den Terminus der „stabilen koronaren Herzerkrankungen“.

• Zu den wesentlichen Komponenten der Sekundärprävention zählen Symptom- und Ischämiereduktion sowie Minimierung der Krankheitsprogression.

• Antianginosa, Plättchenaggregationsregime, Lipidsenkung und Modulatoren des Renin-Angiotensin-Aldosteron-Systems bilden die Grundpfeiler der medikamentösen Therapie.

Schlüsselwörter

Nitrate - chronisches Koronarsyndrom - stabile Angina pectoris - antianginöse Therapie

Key words

nitrates - chronic coronary syndromes - stabile angina - antianginal therapy

Publication History

Article published online:
30 June 2020

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