Der Kardiologe

, Volume 3, Issue 2, pp 81–100 | Cite as

Kommentar zu den Leitlinien der European Society of Cardiology (ESC) zur Diagnose und Therapie des akuten Koronarsyndroms ohne ST-Strecken-Hebung (NSTE-ACS)

  • C.W. Hamm
Leitlinien

Zusammenfassung

Die Europäische Gesellschaft für Kardiologie hat 2007 eine überarbeitete Fassung der Leitlinie zur Diagnose und Therapie des akuten Koronarsyndroms ohne ST-Hebung herausgegeben, die die frühere Leitlinie aus 2002 ablöst. Diese kommentierte Übersetzung wurde von der Deutschen Gesellschaft für Kardiologie verabschiedet und bildet die aktuelle wissenschaftliche Evidenz ab. Erstmals erfolgte eine qualitative Bewertung der Studien, wie z. B. zeitgemäße Begleittherapie, Studiengröße, doppelblindes Studiendesign und harte Endpunkte. Außerdem ging der Sicherheitsaspekt einer Therapie im Sinne des „Efficacy-safety-Profils“ ein. Die Empfehlungen dieser Leitlinie sind praxisnah und erlauben ein zeitgemäßes Management von Patienten mit akutem Koronarsyndrom.

Schlüsselwörter

Leitlinie Akutes Koronarsyndrom Diagnostik Therapie Instabile Angina Myokardinfarkt 

Abkürzungen

ACC

American College of Cardiology

ACE

Angiotensin-converting-Enzym

ACS

Acute Coronary Syndrome

ACT

Activated Clotting Time

ADP

Adenosine Diphosphat

AHA

American Heart Association

aPTT

Activated Partial Thromboplastin Time

AMI

Akuter Myokardinfarkt

ASS

Azetylsalizylsäure (Aspirin)

BNP

Brain Natriuretic Peptide

CABG

Coronary Bypass Graft

CCS

Canadian Cardiovascular Society

CI

Confidence interval

CK

Creatine Kinase

CK-MB

Creatine Kinase Myocardial Band

(hs)CRP

C-reaktives Protein

CT

Computertomographie

cTnT / cTnI

Cardiac Troponin T oder Cardiac Troponin I

DES

Drug eluting stent

DTI

Direkter Thrombininhibitor

EKG

Elektrokardiogramm

EF

Ejektionsfraktion

ESC

European Society of Cardiology

Factor-Xa

Activated Factor X

FFP

Fresh frozen plasma

GFR

Glomerular Filtration Rate

GPIIb/IIIa

Glypoprotein IIb–IIIa

HIT

Heparin-induzierte Thrombozytopenie

HR

Hazard Ratio

IU

International Units

LV

links-ventrikulär

LVEF

links-ventrikuläre Ejektionsfraktion

MRT

Magnetresonanztomographie

NNT

Numbers Needed to Treat

NSTE-ACS

Non-ST-Elevation Acute Coronary Syndromes

NSTEMI

Non-ST Elevation Myocardial Infarction

NT-proBNP

N-terminal Prohormone Brain Natriuretic peptide

OR

Odds Ratio

PCI

Percutaneous Coronary Intervention

RR

Risk Ratio

STEMI

ST-Elevation Myocardial Infarction

UFH

Unfractionated Heparin

Commentary on the guidelines by the European Society of Cardiology (ESC) on the diagnosis and treatment of acute coronary syndrome without ST elevation (NSTE-ACS)

Abstract

In 2007, the European Society of Cardiology published updated guidelines on the diagnosis and treatment of acute coronary syndrome without ST elevation, which replace the previous guidelines of 2004. This commented translation is endorsed by the German Cardiac Society and reflects the current scientific evidence. For the first time, the study quality was weighted, e.g. contemporary adjunctive therapy, study size, double blind design and hard endpoints. In addition, the safety aspect was considered in terms of an efficacy/safety profile. The recommendations are close to clinical practice and allow appropriate management of acute coronary syndrome patients.

Keywords

Guidelines Acute coronary syndrome Diagnosis Therapy Unstable angina Myocardial infarction 

Notes

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: hinterlegt zur Einsichtnahme bei der DGK.

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  • C.W. Hamm
    • 1
  1. 1.Kerckhoff-Klinik, Herz- und ThoraxzentrumBad NauheimDeutschland

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