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DOI: 10.1055/s-0032-1325072
Intervention beim akuten Koronarsyndrom
Coronary Revascularization in Acute Coronary SyndromePublikationsverlauf
Publikationsdatum:
19. August 2013 (online)
![](https://www.thieme-connect.de/media/aktkardio/201304/lookinside/thumbnails/10.1055-s-0032-1325072-1.jpg)
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.
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