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03.09.2018 | Akutes Koronarsyndrom | CME

Management des akuten Koronarsyndroms

verfasst von: PD Dr. med. C. Liebetrau, A. Elsässer, H. Nef, H. Möllmann

Erschienen in: Die Kardiologie | Ausgabe 5/2018

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Zusammenfassung

Das akute Koronarsyndrom (ACS) ist häufig und prognostisch relevant. Insbesondere die kardialen Troponine sind neben dem 12-Kanal-EKG für die Risikostratifizierung und Diagnose wichtig. Mit der Verwendung der hochsensitiven Troponinbestimmung sind im klinischen Alltag eine schnelle Diagnosestellung und Behandlung von Patienten mit akutem Koronarsyndrom ohne ST-Streckenhebung (NSTE-ACS) möglich. Der Zeitpunkt der Koronarangiographie ist abhängig von der klinischen Situation und sollte bei Patienten mit STEMI ohne Verzögerung innerhalb von 120 min nach medizinischem Erstkontakt erfolgen. Bei NSTE-ACS-Patienten mit nachgewiesener Troponindynamik sollte die invasive Diagnostik innerhalb von 24 h, bei Hochrisikopatienten umgehend erfolgen. Unabhängig von der Revaskularisationsstrategie sollte eine duale antithrombozytäre Therapie mit Ticagrelor oder Prasugrel unter Berücksichtigung von Kontraindikationen für 12 Monate erfolgen. Clopidogrel ist nur noch bei Patienten mit einer Indikation zur oralen Antikoagulation oder bei Patienten mit stattgehabter zerebraler Blutung zu verwenden.
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Metadaten
Titel
Management des akuten Koronarsyndroms
verfasst von
PD Dr. med. C. Liebetrau
A. Elsässer
H. Nef
H. Möllmann
Publikationsdatum
03.09.2018
Verlag
Springer Medizin
Erschienen in
Die Kardiologie / Ausgabe 5/2018
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI
https://doi.org/10.1007/s12181-018-0272-3

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