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01.09.2016 | Koronare Herzerkrankung | CME

Nationale Versorgungsleitlinie (NVL) Chronische KHK

Was ist neu, was ist besonders wichtig?

verfasst von: Prof. Dr. med. K. Werdan

Erschienen in: Herz | Ausgabe 6/2016

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Zusammenfassung

Von der Volkskrankheit „koronare Herzkrankheit“ (KHK) ist jeder zehnte 40- bis 79-Jährige in Deutschland betroffen. Im Rahmen der Nationalen Versorgungsleitlinie (NVL) Chronische KHK wurden evidenz- und expertenbasierte Empfehlungen zur Diagnosestellung der chronischen stabilen KHK sowie zur Behandlung und Betreuung der KHK-Patienten im inter-/multidisziplinären Kontext erarbeitet mit den Schwerpunkten Diagnostik, Prävention, medikamentöse und Revaskularisationstherapie, Rehabilitation, hausärztliche Betreuung und Versorgungskoordination. Empfehlungen zur Optimierung der Zusammenarbeit aller beteiligten Ärztegruppen sowie die Definition des Notwendigen und Angemessenen sind wesentliche Intentionen dieser Leitlinie und haben das Ziel, die Qualität der Versorgung zu verbessern und die Stellung des Patienten zu stärken.

Montalescot G, Sechtem U, Achenbach S, Andreotti F et al (2013) ESC guidelines on the management of stable coronary artery disease: The task force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003PubMedCrossRef

Sechtem U, Achenbach S, Gitt AK, Marx N et al (2015) Kommentar zu den 2013 Leitlinien der Europäischen Gesellschaft für Kardiologie (ESC) zum Management der stabilen koronaren Herzkrankheit (KHK). Kardiologe 9:159–164CrossRef

Sechtem U, Achenbach S, Gitt AK, Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung (2013) ESC Pocket Guidelines Management der stabilen koronaren Herzkrankheit (KHK)

Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) (2016) Nationale VersorgungsLeitlinie Chronische KHK – Langfassung, 4. Aufl. doi:10.610/AZQ/000267.

Harbour R, Miller J (2001) A new system for grading recommendations in evidence based guidelines. BMJ 323(7308):334–336PubMedPubMedCentralCrossRef

Europarat, Verbindung der Schweizer Ärztinnen und Ärzte, Ärztliche Zentralstelle Qualitätssicherung (ÄZQ), Europarat, Verbindung der Schweizer Ärztinnen und Ärzte (2001) Entwicklung einer Methodik für die Ausarbeitung von Leitlinien für optimale medizinische Praxis. Empfehlung Rec 13 des Europarates am 10. Oktober 2001 und Erläuterndes Memorandum. Deutschsprachige Ausgabe. Z Arztl Fortbild Qualitatssich 96(Suppl III):3–60

Guyatt GH, Oxman AD, Vist GE et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336(7650):924–926PubMedPubMedCentralCrossRef

Gosswald A, Schienkiewitz A, Nowossadeck E et al (2013) Prävalenz von Herzinfarkt und koronarer Herzkrankheit bei Erwachsenen im Alter von 40 bis 79 Jahren in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 56(5–6):650–655PubMedCrossRef

Deutsche Herzstiftung (2015) Deutscher Herzbericht 2015

10.

Gesundheitsberichterstattung des Bundes (GBE) (2015) Statistik der häufigsten Todesursachen 2003–2013. http:/www.gbe-bund.de. Zugegriffen: 24. März 2015

11.

Daly CA, de Stavola B, Sendon JL et al (2006) Predicting prognosis in stable angina – results from the Euro heart survey of stable angina: prospective observational study. BMJ 332(7536):262–267PubMedPubMedCentralCrossRef

12.

Bosner S, Haasenritter J, Becker A et al (2010) Ruling out coronary artery disease in primary care: development and validation of a simple prediction rule. CMAJ 182(12):1295–1300PubMedPubMedCentralCrossRef

13.

Haasenritter J, Bosner S, Vaucher O et al (2012) Ruling out coronary heart disease in primary care: external validation of a clinical prediction rule. Br J Gen Pract 62(599):e415–e421PubMedPubMedCentralCrossRef

14.

Gorenoi V, Schonermark MP, Hagen A (2012) CT coronary angiography vs. invasive coronary angiography in CHD. GMS Health Technol Assess 8:Doc02PubMedPubMedCentral

15.

Von Ballmoos MW, Haring B, Juillerat P et al (2011) Meta-analysis: diagnostic performance of low-radiation-dose coronary computed tomography angiography. Ann Intern Med 154(6):413–420CrossRef

16.

Gianrossi R, Detrano R, Mulvihill D et al (1989) Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation 80(1):87–98PubMedCrossRef

17.

Gibbons RJ, Balady GJ, Bricker JT et al (2002) ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol 40(8):1531–1540PubMedCrossRef

18.

Kwok Y, Kim C, Grady D et al (1999) Meta-analysis of exercise testing to detect coronary artery disease in women. Am J Cardiol 83(5):660–666PubMedCrossRef

19.

Mant J, McManus RJ, Oakes RA et al (2004) Systematic review and modelling of the investigation of acute and chronic chest pain presenting in primary care. Health Technol Assess 8(2):iii2–iii158CrossRef

20.

Gorenoi V, Schönemark MP, Hagen A (2011) Percutaneous coronary intervention with optimal medical therapy vs. optimal medical therapy alone for patients with stable angina pectoris. GMS Health Technol Assess 7:Doc07PubMedPubMedCentral

21.

Lichtman JH, Froelicher ES, Blumenthal JA et al (2014) Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation 129(12):1350–1369PubMedCrossRef

22.

Nicholson A, Kuper H, Hemingway H (2006) Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J 27(23):2763–2774PubMedCrossRef

23.

Ladwig KH, Lederbogen F, Albus C et al (2013) Positionspapier zur Bedeutung psychosozialer Faktoren in der Kardiologie. Update 2013. Kardiologe 7(1):7–27CrossRef

24.

The EuroQoL Group (1990) EuroQoL – a new facility for the measurement of health-related quality of life. Health Policy (New York) 16(3):199–208

25.

Chaudhury R, Khan H, Heydon E et al (2013) Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J 34(38):2940–2948CrossRef

26.

Naderi SH, Bestwick JP, Wald DS (2012) Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med 125(9):882–887PubMedCrossRef

27.

Piepoli MF, Hoes AW, Agewall S et al (2016) 2016 European Guidelines on cardiovascular disease prevention in clinical practice. The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Eur Heart J. doi:10.1093/eurheartj/ehw106

28.

Gohlke H, Gielen S, König W, Schuler G et al (2012) Prävention von Herz- Kreislauf-Erkrankungen Update 2012 (ESC POCKET GUIDELINES). Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung,

29.

Schuler GC, Koenig W, Adams V, Gohlke H (2013) Kommentar zu den neuen Leitlinien (2012) der Europäischen Gesellschaft für Kardiologie zur kardiovaskulären Prävention. Kardiologe 7:251–260CrossRef

30.

Mukamal KJ, Chen CM, Rao SR, Breslow RA (2010) Alcohol consumption and cardiovascular mortality among U.S adults, 1987 to 2002. J Am Coll Cardiol 55(13):1328–1335PubMedCrossRef

31.

Cannon CP, Blazing MA, Giugliano RP, IMPROVE-IT Investigators et al (2015) Ezetimibe added to Statin therapy after acute coronary syndromes. N Engl J Med 372(25):2387–2397PubMedCrossRef

32.

Jarcho JA, Keaney JF Jr (2015) Proof that lower is better – LDL cholesterol and IMPROVE-IT. N Engl J Med 372(25):2448–2450PubMedCrossRef

33.

Arzneimittelbrief (2016) Beschlüsse des Gemeinsamen Bundesausschusses (G- BA) zur frühen Nutzenbewertung neuer Arzneimittel – Alirocumab. Arzneimittelbrief 50(6):48

34.

Robinson JG, Farnier M, Krempf M, ODYSSEY LONG TERM Investigators et al (2015) Efficacy and safety of Alirocumab in reducing lipids and cardiovascular events. N Engl J Med 372(16):1489–1499PubMedCrossRef

35.

Sabatine MC, Giugliano RP, Wiviott SD, Open-Label Study of Long- Term Evaluation against LDL Cholesterol (OSLER) Investigators et al (2015) Efficacy and Safety of Evolocumab in Reducing Lipids and Cardiovascular Events. N Engl J Med 372(16):1500–1509PubMedCrossRef

36.

Stone NJ, Lloyd-Jones DM (2015) Lowering LDL cholesterol is good, but how and in whom? N Engl J Med 372(16):1564–1565PubMedCrossRef

37.

Kezerashvili A, Marzo K, De Leon J (2012) Beta blocker use after acute myocardial infarction in the patient with normal systolic function: when is it „ok“ to discontinue? Curr Cardiol Rev 8:77–84PubMedPubMedCentralCrossRef

38.

Jochmann, Stangls K, Garbe E et al (2005) Female-specific aspects in the pharmacotherapy of chronic cardiovascular diseases. Eur Heart J 26(16):1585–1595PubMedCrossRef

39.

Olsson G, Wikstrand J, Warnold I et al (1992) Metoprolol-induced reduction in postinfarction mortality: pooled results from five double-blind randomized trials. Eur Heart J 13(1):28–32PubMed

40.

Freemantle N, Cleland J, Young P et al (1999) Beta Blockade after myocardial infarction: systematic review and meta regression analysis. BMJ 318(7200):1730–1737PubMedPubMedCentralCrossRef

41.

Law MR, Morris JK, Wald NJ (2009) Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 338:b1665PubMedPubMedCentralCrossRef

42.

Andersson C, Shilane D, Go AS et al (2014) Beta-blocker therapy and cardiac events among patients with newly diagnosed coronary heart disease. J Am Coll Cardiol 64(3):247–252PubMedCrossRef

43.

Bangalore S, Steg PG, Deedwania P, REACH Registry Investigators et al (2012) β‑blocker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA 308(13):1340–1349PubMedCrossRef

44.

Steg PG, De Silva R (2014) Beta-blockers in asymptomatic coronary artery disease – no benefit or no evidence? J Am Coll Cardiol 64(3):253–255PubMedCrossRef

45.

Ghali JK, Pina IL, Gottlieb SS et al (2002) Metoprolol CR/XL in female patients with heart failure: analysis of the experience in Metoprolol Extended-Release Randomized Intervention Trial in Heart Failure (MERIT-HF). Circulation 105(13):1585–1591PubMedCrossRef

46.

Klapholz M (2009) β‑blocker use for the stags of heart failure. Mayo Clin Proc 84(8):718–729PubMedPubMedCentralCrossRef

47.

Shibata MC, Flather MD, Wang D (2001) Systematic review of the impact of beta blockers on mortality and hospital admissions in heart failure. Eur J Heart Fail 3:351–357PubMedCrossRef

48.

Kotecha D, Holmes J, Krum H, Beta-Blocker in Heart Failure Collaborative Group et al (2014) Efficacy of β blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis. Lancet 384:2235–2243PubMedCrossRef

49.

Goldberger JJ, Bonow RO, Cuffe M, OBTAIN Investigators et al (2015) Effect of Beta-Blocker Dose on Survival After Acute Myocardial Infarction. J Am Coll Cardiol 66(13):1431–1441PubMedCrossRef

50.

Fox K, Steg PG, Tendera M, BEAUTIFU’L Investigators (2008) Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomized, double-blind, placebo- controlled trial. Lancet 372:807–816PubMedCrossRef

51.

Swedberg K, Komajda M, Böhm M, SHIFT Investigators et al (2010) Ivabradine and outcomes in chronic heart failure (SHIFT): a randomized placebo-controlled study. Lancet 376:875–885PubMedCrossRef

52.

Kjekshus JK (1986) Importance of heart rate in determining beta-blocker efficacy in acute and long-term acute myocardial infarction intervention trials. Am J Cardiol 57:43F–49FPubMedCrossRef

53.

Menown IBA, Davies S, Gupta S et al (2013) Resting heart rate and outcomes in patients with cardiovascular disease: where do we currently stand? Cardiovasc Ther 31:215–223PubMedPubMedCentralCrossRef

54.

Fox K, Ford I, Steg PG, SIGNIFY Investigators et al (2014) Ivabradine in stable coronary artery disease without clinical heart failure. N Engl J Med 371(12):1091–1099PubMedCrossRef

55.

Abd El Azeem H, Abd El Khalek ES, El Akabawy H (2011) Evaluation of aggressive heart rate reduction in patients with stable angina. J Saudi Heart Assoc 23:67–73CrossRef

56.

Werdan K, Perings S, Köster R et al (2016) Effectiveness of Ivabradine treatment in different subpopulations with stable angina in clinical practice: A pooled analysis of observational studies. Cardiology 135:141–150PubMedCrossRef

57.

McMurray JJV, ATMOSPHRE Committee Investigators et al (2016) Aliskiren, Enalapril, or Aliskiren and Enalapril in heart failure. N Engl J Med 374(16):1521–1532PubMedCrossRef

58.

Ponikowski P et al (2016) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology. Developed with the special contribution of the Heart Failure association (HFA) of the ESC. Eur Heart J:. doi:10.1093/eurheartj/ehw128 PubMedCentral

59.

McMurray JJV, PARADIGM-HF Investigators and Committees et al (2014) Angiotensin-Neprilysin inhibition versus Enalapril in heart failure. N Engl J Med 371(11):993–1004PubMedCrossRef

60.

Böhm M, Borer J, Ford I et al (2013) Heart rate at baseline influences the effect of ivabradine on cardiovascular outcomes in chronic heart failure: analysis from the SHIFT study. Clin Res Cardiol 102:11–22

61.

Weisz G, Généreux P, Iniguez A, RIVER-PCI investigators et al (2016) Ranolazine in patients with incomplete revascularisation after percutaneous coronary intervention (RIVER-PCI): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet 387(10014):136–145PubMedCrossRef

62.

Alexander KP, Weisz G, Prather K, James S et al (2016) Effects of Ranolazine on angina and quality of life after Percutaneous coronary intervention with incomplete Revascularization – results from the Ranolazine for Incomplete Vessel Revascularization (RIVER-PCI) trial. Circulation 133(1):39–47PubMedCrossRef

63.

Robert Koch Institut (RKI) (2010) Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut/Stand Juli 2010. EI 30:279–98. Aktuelle Ausgabe: 22. Februar 2016/Nr. 7, S 57–66

64.

Thomas S, Gokhale R, Boden WE et al (2013) A meta-analysis of randomized controlled trials comparing percutaneous coronary intervention with medical therapy in stable angina pectoris. Can J Cardiol 29(4):472–482PubMedCrossRef

65.

Stergiopolous K, Boden WE, Hartigan P et al (2014) Percutaneous coronary intervention outcomes in patients with stable obstructive coronary artery disease and myocardial Ischemia: A collaborative meta-analysis of contemporary randomized clinical trials. JAMA Intern Med 174(2):232–240CrossRef

66.

Stergiopolous K, Boden WE (2012) Initial coronary stent implantation with medical therapy vs. medical therapy alone for stable coronary artery disease: meta-analysis of randomized controlled trials. Arch Intern Med 172(4):312–319CrossRef

67.

Pursnani S, Korley F, Gopaul R et al (2012) Percutaneous coronary intervention versus optimal medical therapy in stable coronary artery disease: a systematic review and meta-analysis of randomized clinical trials. Circ Cardiovasc Interv 5(4):476–490PubMedCrossRef

68.

Bangalore S, Pursnani S, Kumar S et al (2013) Percutaneous coronary intervention versus optimal medical therapy for prevention of spontaneous myocardial infarction in subjects with stabe ischemic heart disease. Circulation 127(7):789–781CrossRef

69.

Sedlis SP, Hartigan PM, Teo KK, Maron DJ, COURAGE Trial Investigators et al (2015) Effects of PCI on long-term survival in patients with stable ischemic heart disease. N Engl J Med 373(20):1937–1946PubMedCrossRef

70.

Hueb W, Lopes N, Gersh BJ et al (2010) Ten-year follow-up survival of the Medicine, Angioplasty, or Surgery Study (MASS II): a randomized controlled trial of 3 therapeutic strategies for multivessel coronary artery disease. Circulation 122(10):949–957PubMedCrossRef

71.

Jeremias A, Kaul S, Rosengart TK et al (2009) The impact of revascularization on mortality in patients with nonacute coronary artery disease. Am J Med 122(2):152–161PubMedCrossRef

72.

Yusuf S, Zucker D, Peduzzi P et al (1994) Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomized trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet 344(8922):563–570

73.

Velasquez EJ, Lee KL, Deja MA et al (2011) Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med 364(17):1607–1616CrossRef

74.

Velasquez EJ, STICHES Investigators et al (2016) Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy. N Engl J Med 374(16):1511–1520CrossRef

75.

Wijeysundera HC, Nallamothu BK, Krumholz HM et al (2010) Meta-analysis: effects of percutaneous coronary intervention versus medical therapy on angina relief. Ann Intern Med 152(6):370–379PubMedCrossRef

76.

Li Q, Zhang Z, Yin RX (2013) Drug-eluting stents or coronary artery bypass grafting for nonprotected left main coronary artery disease: a meta-analysis of four randomized trials and seventeen observation studies. Trials 14:33CrossRef

77.

Sipahi I, Akay MH, Dagdelen S et al (2014) Coronary artery bypss grafting vs percutaneous coronary intervention and long-term mortality and morbidity in multivessel disease: meta-analysis of randomized clinical trials of the arterial grafting and stenting era. JAMA Intern Med 174(2):223–230PubMedCrossRef

78.

Boden WE, O’Rourke RA, Teo KK et al (2007) Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 356(15):1503–1515PubMedCrossRef

79.

Windecker S, Kolh P, Alfonso F et al (2014) 2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 35:2541–2619PubMedCrossRef

80.

De Bruyne B, Pijls NH, Kalesan B, FAME 2 Trial Investigators et al (2012) Fractional flow reserve-guided PCI vs. medical therapy in stable coronary disease. N Engl J Med 367(11):991–1001PubMedCrossRef

81.

Serruys PW, Morice MC, Kappetein AP et al (2009) Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 360(10):961–972PubMedCrossRef

82.

Farkouh ME, Domanski M, Sleeper LA et al (2012) Strategies for multivessel revascularization in patients with diabetes. N Engl J Med 360(24):2503–2515

83.

Frye RL, August P, Brooks MM et al (2009) A raondomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med 360(24):2503–2515PubMedCrossRef

84.

Kappetein AP, Head SJ, Morice MC et al (2013) Treatment of complex coronary artery disease in patients with diabetes: 5 year results comparing outcomes of bypass surgery and percutaneous coronary intervention in the SYNTAX trial. Eur J Cardiothorac Surg 43(5):1006–1013PubMedCrossRef

85.

Kapur A, Hall RJ, Malik IS et al (2010) Randomized comparison of percutaneous coronary intervention with coronary artery bypass grafting in diabetic patients. 1‑year results of the CARDia (Coronary Artery Revascularization in Diabetes) trial. J Am Coll Cardiol 55(5):432–440PubMedCrossRef

86.

Weintraub WS, Grau-Sepulveda MV, Weiss JM et al (2012) Comparative effectiveness of revascularization strategies. N Engl J Med 366(12):1467–1476PubMedPubMedCentralCrossRef

87.

Deb S, Wijeysundera HC, Ko DT et al (2013) Coronary artery bypass graft surgery vs percutaneous coronary interventions in coronary revacularization: a systematic review. JAMA 310(19):2086–2095PubMedCrossRef

88.

Hakeem A, Garg N, Bhatti S et al (2013) Effectiveness of percutaneous coronary intervention with drug – Eluting stents compared with bypass surgery in diabetics with multivessel coronary disease comprehensive systematic review and meta-analysis of randomized clinical data. J Am Heart Assoc 2(4):e000354PubMedPubMedCentralCrossRef

89.

Li X, Kong M, Jiang D et al (2014) Comparing coronary artery bypass grafting with drug-eluting stenting in patients with diabetes mellitus and multivessel coronary artery disease: a meta-analysis. Interact Cardiovasc Thorac Surg 18(3):347–354PubMedCrossRef

90.

Fischbach W, Darius H, Gross M et al (2010) Gleichzeitige Anwendung von Thrombozytenaggregationshemmern und Protonenpumpeninhibitoren (PPIs). Positionspapier der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Kardiologie (DKG). Z Gastroenterol 48:1156–1163PubMedCrossRef

91.

Lip GYH, Windecker S, Huber K et al (2014) Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HrS) and Asia-Pacific Heart Rhythm Society (APHRS). Eur Heart J 35:3155–3179PubMedCrossRef

92.

Ärztliches Zentrum für Qualität in der Medizin (ÄZQ) (2003) Leitlinien- Clearingbericht „Koronare Herzkrankheit“ Niebüll:videel; (äzq Schriftenreihe 11)

93.

Baigent C, Blackwell L, Collins R et al (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomized trials. Lancet 373(9678):1849–1860PubMedCrossRef

94.

Anand SS, Yusuf S (1999) Oral anticoagulant therapy in patients with coronary artery disease: a meta-analysis. JAMA 282(21):2058–2067PubMedCrossRef

95.

Dentali F, Douketis JD, Lim W et al (2007) Combined aspirin-oral anticoagulant therapy compared with oral anticoagulant therapy alone among patients at risk for cardiovascular disease: a meta-analysis of randomized trials. Arch Intern Med 167(2):117–124PubMedCrossRef

96.

Hurlen M, Abdelnoor M, Smith P et al (2002) Warfarin, aspirin, or both after myocardial infarction. N Engl J Med 347(13):969–974PubMedCrossRef

97.

Arzneimittelkommission der deutschen Ärzteschaft (AkdÄ) (2009) Arzneiverordnungen. Empfehlungen zur rationalen Pharmakotherapie, 22. Aufl. MMI, Neu-Isenburg

98.

Liao JK, Laufs U (2005) Pleiotropic effects of statins. Annu Rev Pharmacol Toxicol 45:89–118PubMedPubMedCentralCrossRef

99.

Baigent C, Keech A, Kearney PM et al (2005) Efficacy and safety of cholesterol- lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 366(9493):1267–1278PubMedCrossRef

100.

Cholesterol Treatment Trialists’ (CTT) Collaboration (2010) Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. Lancet 376(9753):1670–1681CrossRef

101.

Delahoy PJ, Magliano DJ, Webb K et al (2009) The relationship between reduction in low-density lipoprotein cholesterol by statins and reduction in risk of cardiovascular outcomes: an updated meta-analysis. Clin Ther 31(2):236–244PubMedCrossRef

102.

Regitz-Zagrosek V, Schubert C, Kruger S (2008) Geschlechterunterschiede in der kardiovaskulären Pharmakotherapie. Internist 49(11):1383–1390PubMedCrossRef

103.

Thadani U, Rodgers T (2006) Side effects of using nitrates to treat angina. Expert Opin Drug Saf 5(5):667–674PubMedCrossRef

104.

Farooq V, van Klaveren D, Steyerberg ES et al (2013) Anatomical and clinical characterisitics to guide decision making between coronary artery bypass surgery and percutaneous coronary intervention for individual patients: development and validation of SYNTAX score II. Lancet 381(9867):639–650PubMedCrossRef

Titel: Nationale Versorgungsleitlinie (NVL) Chronische KHK
Was ist neu, was ist besonders wichtig?
verfasst von: Prof. Dr. med. K. Werdan
Publikationsdatum: 01.09.2016
Verlag: Springer Medizin
Schlagwörter: Koronare Herzerkrankung
KHK in der Hausarztpraxis
Internistische Arzneimitteltherapie
Prävention und Rehabilitation in der Kardiologie
CABG
Diagnostik in der Kardiologie
Erschienen in: Herz / Ausgabe 6/2016
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-016-4474-9

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Nationale Versorgungsleitlinie (NVL) Chronische KHK

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Neu im Fachgebiet Kardiologie

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