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Hamostaseologie 1992; 12(02): 057-067
DOI: 10.1055/s-0038-1660317
Übersichtsarbeit/Review Articles
Schattauer GmbH

Wahl des Thrombolytikums und Erfolg der Thrombolyse bei Myokardinfarkt

G. Görge
1   II. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität Mainz (Direktor: Prof. Dr. J. Meyer)
,
J. Meyer
1   II. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität Mainz (Direktor: Prof. Dr. J. Meyer)
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Publication History

Publication Date:
26 June 2018 (online)

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Zusammenfassung

Bei der Infarktletalität haben die GISSI-1- und ISIS-2-Studie die Überlegenheit von Streptokinase i. v. gegenüber Plazebo gezeigt. Bei dem Vergleich von rt-PA i.v. gegen Streptokinase i.v. in der GISSI-2-und der ISIS-3-Studie ergaben sich im Hinblick auf die Sterblichkeit allerdings keine signifikanten Unterschiede. Diese Ergebnisse sind so nicht erwartet worden, da rt-PA schneller mehr Gefäße wiedereröffnet als Streptokinase. Kritisiert wurde die Art der Heparinapplikation bei der GISSI-2-Studie mit Beginn einer subkutanen Gabe von 12 500 E erst 12 Stunden nach Lysebeginn, was für den rt-PA mit seiner kurzen Halbwertszeit nachteilig gewesen sein muß. Neue Dosierungsschemata für rt-PA (»front-loading«) und die Kombination von Thrombolytika (rt-PA + ProUrokinase) führten zu höheren Patency-Raten. Ob dies in Zukunft zu einer niedrigeren Infarktletalität führen wird, werden erst größere Studien zeigen können.

Schlüsselwörter

Myokardinfarkt - akuter - Thrombolyse - Koronarangiographie

Keywords

Myocardial - infarction - thrombolysis - coronary angiography
 

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