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Kardiologie up2date 2005; 1(3): 200-208
DOI: 10.1055/s-2005-870395
Hotline - Koronare Herzerkrankung und Arteriosklerose
© Georg Thieme Verlag KG Stuttgart · New York

Plättchenhemmung als Therapieprinzip der Primär- und Sekundärprophylaxe bei koronarer Herzkrankheit

Felix  Post
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Publication History

Publication Date:
09 September 2005 (online)

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Einleitung

Die koronare Herzerkrankung (KHK) ist die Manifestation der Atherosklerose an den Herzkranzarterien. In den Frühstadien der Erkrankung sind in der Regel keine klinischen Symptome vorhanden, obwohl die endotheliale Funktion bereits gestört und Lipide in der Gefäßwand eingelagert sind. Bei Plaquerupturen kommt es durch rasche Aktivierung von Thrombozyten zu akuten Ischämiesyndromen. Hier ist der Hauptansatzpunkt der Thrombozytenaggregationshemmer.

Nachdem ASS seit langem den Therapiestandard darstellt, haben Thienopyridine und Glykoprotein-IIb/IIIa-Rezeptorantagonisten in den letzten Jahren bei bestimmten Indikationen zunehmend an Bedeutung gewonnen. Wegen der neuen Definition des akuten Koronarsyndroms und wegen der Ergebnisse neuerer, sehr großer Therapiestudien haben alle großen kardiologischen Gesellschaften ihre Leitlinien aktualisiert. Im Folgenden soll der Stellenwert der Thrombozytenaggregationshemmung bei der Therapie von verschiedenen Manifestationen der KHK aufgezeigt werden.

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Dr. med. Felix Post

II. Medizinische Klinik und Poliklinik

Klinikum der Johannes Gutenberg-Universität · Langenbeckstr. 1 · 55131 Mainz

Email: post@2-med.klinik.uni-mainz.de