Akutes Koronarsyndrom: Risikostratifizierung und Therapie

In der klinischen Praxis wird der Begriff als Arbeitsdiagnose für allen Patienten mit neu aufgetretenem Thoraxschmerz verwendet, bei denen eine signifikante myokardiale Minderperfusion als Schmerzursache vermutet wird.

Schlüsselwörter

Myokardinfarkt - EKG - Angina pectoris - Brustschmerz - Risikostratifizierung

• Literatur

• 1 Harrisons Innere Medizin. Suttorp N, Möckel M, Siegmund B, Dietel M. 20. Stuttgart: Thieme/ABW Wissenschaftsverlag; 2020.
• 2 Juhani K, William W, Antti S. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 2020; 41: 407-477
• 3 Thygesen K, Alpert JS, Jaffe AS. et al. ESC-Pocket Guidelines: Vierte Definition des Myokardinfarktes (Version 2018). Grünwald: Börm Bruckmeier; 2018
• 4 Scholz J, Gräsner J, Bohn A. Referenz Notfallmedizin. Stuttgart: Thieme; 2019.
• 5 Collet J-P, Thiele H, Barbato E. et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021; 42: 1289-1367
• 6 Hamm CW, Liebetrau C, Dill T, Brandt R. Akutes Koronarsyndrom: instabile Angina pectoris und Myokardinfarkt. In: Arastéh K, Baenkler H, Bieber C, Brandt R, Chatterjee TT. Duale Reihe Innere Medizin. 4. Stuttgart: Thieme; 2018: 83-98
• 7 Hartikainen T. Prädiktiver und diagnostischer Wert von Biomarkern in der Kardiologie. Kardiologie up2date 2018; 14: 159-176
• 8 Zipes DP, Libby P, Bonow RO. Braunwald’s Heart Disease. A Textbook of cardiovascular Medicine. 11. Philadelphia: Elsevier; 2018
• 9 Ibanez B, James S, Agewall S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2018; 39: 119-177
• 10 Di Marco A, Rodriguez M, Cinca J. et al. New electrocardiographic algorithm for the diagnosis of acute myocardial infarction in patients with left bundle branch block. Am Heart Assoc 2020; 9: e015573
• 11 Jaffe AS, Lindahl B, Giannitsis E. et al. A fond farewell at the retirement of CKMB – ESC Study Group on Cardiac Biomarkers of the Association for Acute CardioVascular Care. Eur Heart J 2021; 42: 2260-2264
• 12 Wnorowski AM, Halpern EJ. Diagnostic yield of triple-rule-out ct in an emergency setting. AJR Am J Roentgenol 2016; 207: 295-301
• 13 Giannitsis E, Post F, Haerer W. et al. Kriterien der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung für „Chest Pain Units“. Kardiologe 2020; 14: 466-479
• 14 Center for Outcomes Research, University of Massachusetts Medical School. Global Registry of Acute Coronary Events (GRACE). Accessed November 01, 2021 at: https://www.outcomes-umassmed.org/grace/acs_risk.aspx
• 15 Subherwal S, Bach R, Chen A. et al. Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score. Circulation 2009; 119: 1873-1882
• 16 Nolan J, Sandroni C, Böttiger BW. et al. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines for Post-resuscitation Care 2020. Intensive Care Med 2021; 47: 369-421
• 17 Scholz KH, Andresen D, Böttiger BW. et al. Qualitätsindikatoren und strukturelle Voraussetzungen für Cardiac-Arrest-Zentren – Deutscher Rat für Wiederbelebung/German Resuscitation Council (GRC). Kardiologe 2017; 11: 205-208
• 18 Schuyler Jones W, Mulder H, Wruck LM. et al. Comparative effectiveness of aspirin dosing in cardiovascular disease. N Engl J Med 2021; 384: 1981-1990
• 19 Pharmakotherapie. Klinische Pharmakologie. Lemmer B, Brune K. Berlin, Heidelberg: Springer; 2010
• 20 Montalescot G, Bolognese L, Dudek D. et al. Pretreatment with prasugrel in non-st-segment elevation acute coronary syndromes. N Engl J Med 2013; 369: 999-1010
• 21 Tarantini G, Mojoli M, Varbella F. et al. Timing of oral P2Y12 inhibitor administration in patients with non-ST-segment elevation acute coronary syndrome. J Am Coll Cardiol 2020; 76: 2450-2459
• 22 Bainey K, Engstrøm T, Smits P. et al. Complete vs culprit-lesion-only revascularization for st-segment elevation myocardial infarction a systematic review and meta-analysis. JAMA Cardiol 2020; 5: 881-888
• 23 Thiele H, Akin I, Sandri M. et al. One-year outcomes after PCI strategies in cardiogenic shock. N Engl J Med 2018; 379: 1699-1710
• 24 Liang JJ, Fender EA, Cha YM. et al. Long-term outcomes in survivors of early ventricular arrhythmias after acute ST-elevation and non-ST-elevation myocardial infarction treated with percutaneous coronary intervention. Am J Cardiol 2016; 117: 709-713
• 25 Connolly SJ, Eikelboom JW, Bosch J. et al. Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial. Lancet 2018; 391: 205-218
• 26 Mauri L, Kereiakes DJ, Yeh RW. et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 2014; 371: 2155-2166
• 27 Bonaca MP, Bhatt DL, Cohen M. et al. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med 2015; 372: 1791-1800