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Aktuelle Kardiologie 2013; 2(4): 220-224
DOI: 10.1055/s-0032-1325072
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Intervention beim akuten Koronarsyndrom

Coronary Revascularization in Acute Coronary Syndrome
Sabine Genth-Zotz
1   Innere Medizin I, Katholisches Klinikum, Mainz
,
Eberhard Schulz
2   II. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz
› Author Affiliations
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Publication History

Publication Date:
19 August 2013 (online)

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Zusammenfassung

Das akute Koronarsyndrom wird in ein STE-ACS und ein NSTE-ACS anhand des EKGs unterteilt. Eine weitere Differenzierung des NSTE-ACS erfolgt durch die Troponin-Bestimmung in den NSTEMI und die instabile Angina pectoris. Bei Patienten mit STE-ACS steht die sofortige Revaskularisation im Vordergrund, hier ist die PCI der Fibrinolysetherapie vorzuziehen. Patienten mit NSTE-ACS und hohem Risiko profitieren von einer invasiven Strategie. Als medikamentöse Begleittherapie erhalten die Patienten eine duale plättchenhemmende Therapie über 12 Monate, danach ASS 100 mg lebenslang. Ebenso ist eine strikte Sekundärprävention zu empfehlen.

Abstract

The ACS consists of the STE-ACS and NSTE-ACS which can be diagnosed by ECG. In NSTE-ACS the evaluation of troponin leads to further differentiation between NSTEMI and unstable angina. In STE-ACS early revascularization is crucial and primary PCI is the preferred strategy. In NSTE-ACS risk stratification is necessary to guide therapy. In high risk patients an invasive strategy is recommended. Dual antiplatelet therapy for 12 months, followed by ASS 100 mg livelong should be prescribed to all ACS patients. Furthermore, secondary prevention is crucial.

Schlüsselwörter

ACS - Revaskularisation - adjuvante Therapie

Key words

ACS - revascularization - adjunctive therapy
 

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