Subscribe to RSS
DOI: 10.1055/s-0042-107115
Akutes Koronarsyndrom ohne ST-Streckenhebung
Die neue Leitlinie der Europäischen Gesellschaft für KardiologieThe new 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevationPublication History
Publication Date:
02 June 2016 (online)
![](https://www.thieme-connect.de/media/dmw/201611/lookinside/thumbnails/0782_10-1055-s-0042-107115-1.jpg)
Zusammenfassung
Die Europäische Gesellschaft für Kardiologie hat 2015 aktualisierte Leitlinien zur Diagnostik und Therapie des akuten Koronarsyndroms ohne ST-Streckenhebung veröffentlicht. Der vorliegende Beitrag beschäftigt sich mit einigen der wichtigsten Neuerungen: der Einführung des 1-Stunden-Algorithmus zur Diagnostik mit hochsensitiven Troponin-Assays, der Präzisierung von Zeitvorgaben zur invasiven Strategie, neuen Empfehlungen zur Katheterintervention und periinterventionellen antithrombotische Therapie sowie neuen Aspekten der Sekundärprävention.
Abstract
In 2015 the European Society of Cardiology published a new version of the guidelines for the management of acute coronary syndromes without persistent ST-segment elevation. The current communication addresses some of the most important updates: introduction of the 1-hour diagnostic algorithm with high-sensitivity troponin assays, specified time lines for the invasive strategy, new recommendations for catheter intervention and peri-interventional antithrombotic therapy as well as new aspects of secondary prevention.
-
Literatur
- 1 Hamm CW, Bassand JP, Agewall S et al. ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2011; 32: 2999-3054
- 2 Jernberg T, Hasvold P, Henriksson M et al. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term perspective. Eur Heart J 2015; 36: 1163-1170
- 3 Roffi M, Patrono C, Collet JP et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent st-segment elevation. Eur Heart J 2016; 37: 267-315
- 4 Hochholzer W, Morrow DA, Giugliano RP. Novel biomarkers in cardiovascular disease: Update 2010. Am Heart J 2010; 160: 583-594
- 5 Reichlin T, Schindler C, Drexler B et al. One-hour rule-out and rule-in of acute myocardial infarction using high-sensitivity cardiac troponin T. Arch Intern Med 2012; 172: 1211-1218
- 6 Rubini Gimenez M, Twerenbold R, Jaeger C et al. One-hour rule-in and rule-out of acute myocardial infarction using high-sensitivity cardiac troponin I. Am J Med 2015; 128: 861-870
- 7 Neumann J, Sörensen N, Schwemer T et al. Accurate and rapid diagnosis of myocardial infarction using a high-sensitivity troponin I 1-hour algorithm. ESC Congress 2015; Hotline Session on August 30th 2015
- 8 Navarese EP, Gurbel PA, Andreotti F et al. Optimal timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes: a systematic review and meta-analysis. Ann Intern Med 2013; 158: 261-270
- 9 Mehta SR, Granger CB, Boden WE et al. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med 2009; 360: 2165-2175
- 10 Montalescot G, Bolognese L, Dudek D et al. Pretreatment with prasugrel in non-ST-segment elevation acute coronary syndromes. N Engl J Med 2013; 369: 999-1010
- 11 Bhatt DL, Stone GW, Mahaffey KW et al. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med 2013; 368: 1303-1313
- 12 Valgimigli M, Gagnor A, Calabro P et al. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet 2015; 385: 2465-2476
- 13 Palmerini T, Biondi-Zoccai G, Della Riva D et al. Stent thrombosis with drug-eluting and bare-metal stents: evidence from a comprehensive network meta-analysis. Lancet 2012; 379: 1393-1402
- 14 Bangalore S, Toklu B, Amoroso N et al. Bare metal stents, durable polymer drug eluting stents, and biodegradable polymer drug eluting stents for coronary artery disease: mixed treatment comparison meta-analysis. BMJ 2013; 347: f6625
- 15 Mauri L, Kereiakes DJ, Yeh RW et al. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 2014; 371: 2155-2166
- 16 Bonaca MP, Bhatt DL, Cohen M et al. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med 2015; 372: 1791-1800
- 17 Cannon CP, Blazing MA, Giugliano RP et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med 2015; 372: 2387-2397