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Hamostaseologie 2005; 25(01): 6-12
DOI: 10.1055/s-0037-1619648
Original Article
Schattauer GmbH

Antithrombotische Therapie bei akutem Koronarsyndrom

Antithrombotic therapy of acute coronary syndromes
H. Hölschermann
1   Medizinische Klinik I, Kardiologie und Angiologie, Zentrum für Innere Medizin, Universitätsklinikum Gießen
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Publication History

Publication Date:
27 December 2017 (online)

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Zusammenfassung

In Deutschland werden jährlich etwa 350 000–400 000 Patienten mit akutem Koronarsyndrom ohne persistierende ST-Streckenhebung (instabile Angina pectoris und Nicht-ST-Hebungsinfarkt) behandelt. Gemeinsames pathophysiologisches Substrat beider klinisch akut lebensbedrohlichen Manifestationsformen der koronaren Herzerkrankung ist in aller Regel die Erosion oder Ruptur der atherosklerotischen Plaque, die zur Thromboyztenaktivierung und Thrombusbildung führt. Die antithrombotische Therapie ist ein zentraler Bestandteil der Therapie der akuten Koronarsyndrome. In den vergangenen Jahren ist das Gebiet der plättchenhemmenden und antithrombotischen Therapie um einige neue Wirkstoffe bereichert worden, die die Prognose von Patienten mit akutem Koronarsyndrom verbessert haben. Diese Arbeit stellt die aktuellen Empfehlungen zur kombinierten gerinnungshemmenden Therapie bei akutem Koronarsyndrom ohne ST-Streckenhebung (instabile Angina pectoris und NSTEMI) zusammenfassend dar.

Summary

Recent advances in the diagnosis and the treatment of acute coronary syndromes (ACS) have led to a substantial reduction of major coronary events, to an improvement in patient outcome, and to the definition of new guidelines. Current strategies for the treatment of patients with non-STelevation ACS recommend a combined antithrombotic therapy (including acetyl salicylic acid, clopidogrel, low-molecular weight or unfractionated heparins and, eventually glycoprotein IIb/IIIa receptor antagonists). This combined antithrombotic therapy allows to increase the benefit of an early invasive strategy including coronary angiogram with stent percutaneous coronary angioplasty. The purpose of this review is to discuss and highlight the actual recommendations for the appropriate use of antithrombotic strategies for ACS patients.

Schlüsselwörter

Antithrombotika - akutes Koronarsyndrom - Plättchenhemmung

Keywords

Acute coronary syndromes - antithrombotic therapy
 

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