Neue „universelle” Infarktdefinition - Relevanz für den klinischen Alltag

Abstract

Myocardial infarction (MI) as an acute and life threatening complication of coronary heart disease is one of the most frequent causes of death in Germany and thus is of great clinical relevance. Diagnostic criteria have been defined in a consensus document „Universal Definition of Myocardial Infarction”, which has been published at the end of 2007. Here, cardiac markers, namely cardiac troponins, play a central role as a criterion for the diagnosis of myocardial infarction in conjunction with clinical signs, ECG changes or specific findings in non invasive imaging. Furthermore, this current definition provides unequivocal criteria for the diagnosis of myocardial infarction after therapeutic procedures (PCI and CABG).

Literatur

• 1 Bundesamt S. Todesursachen .Online im Internet: http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Statistiken/Gesundheit/Todesursachen/Tabellen/Content75/SterbefaelleInsgesamt,templateId=renderPrint.psml
• 2 Nomenclature and criteria for diagnosis if ischemic heart disease: report of the Joint International Society and Federation of Cardiology/World Health Organization Task Force on Standardization of Clinical Nomenclature.  Circulation. 1979;  59 607-609
• 3 Myocardial infarction redefined - a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction.  Eur Heart J. 2000;  21 1502-1513
• 4 Thygesen K, Alpert J S, White H D. Universal definition of myocardial infarction.  Eur Heart J. 2007;  28 2525-2538
• 5 Bassand J P, Hamm C W, Ardissino D. et al . Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes.  Eur Heart J. 2007;  28 1598-1660
• 6 Hamm C W. Guidelines: Acute coronary syndrome (ACS). II: Acute coronary syndrome with ST-elevation.  Z Kardiol. 2004;  93 324-341
• 7 Hamm C W. Guidelines: acute coronary syndrome (ACS). 1: ACS without persistent ST segment elevations.  Z Kardiol. 2004;  93 72-90
• 8 Panteghini M, Pagani F, Yeo K T. et al . Evaluation of imprecision for cardiac troponin assays at low-range concentrations.  Clin Chem. 2004;  50 327-332
• 9 Kavsak P A, MacRae A R, Lustig V. et al . The impact of the ESC/ACC redefinition of myocardial infarction and new sensitive troponin assays on the frequency of acute myocardial infarction.  Am Heart J. 2006;  152 118-125
• 10 Salomaa V, Koukkunen H, Ketonen M. et al . A new definition for myocardial infarction: what difference does it make?.  Eur Heart J. 2005;  26 1719-1725