Koronarinterventionen im höheren Lebensalter beim akuten Koronarsyndrom - Wann ist ein konservatives, wann ein invasives Vorgehen angezeigt?

Die perkutane Koronarintervention (PCI) ist ein sicheres und effektives Verfahren zur Wiederherstellung der Myokardperfusion. Allerdings steigt mit zunehmendem Alter das Komplikationsrisiko des Verfahrens. Vorteilhaft kann das invasive Vorgehen beim akuten Koronarsyndrom dennoch auch bei älteren Patienten sein - insbesondere wenn ein ST-Strecken-Hebungsinfarkt vorliegt -, während bei der stabilen koronaren Herzkrankheit eine konservative der invasiven Therapie bezüglich der Prognose ebenbürtig ist. Bei der individuellen Entscheidung für oder gegen eine interventionelle Behandlung sollten neben dem biologischen Alter, die Begleiterkrankungen sowie die Koronaranatomie eines jeden Patienten mit in die Entscheidung einfließen.

Percutaneous coronary intervention (PCI) is a safe and effective procedure to reconstitute myocardial perfusion. With advancing age patients face a higher risk for complications of PCI. In elderly patients with acute coronary syndromes especially those with STEMI an invasive strategy with PCI improves the prognosis, whereas in stable coronary heart disease a conservative approach is equally effective. Individual decisions in favour of or contrary to an interventional treatment should be based on the biological age, concomitant diseases and coronary anatomy of the patient.

Key words

percutaneous coronary intervention - age - complications - acute coronary syndromes

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1 Trial of Invasive versus Medical therapy in Elderly patients

2 Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy - Thrombolysis In Myocardial Infarction

3 Maximal Individual Therapy in Acute Myocardial Infarction

4 Primary Angioplasty in Myocardial Infarction in the elderly

5 Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte

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