MMW - Fortschritte der Medizin

, Volume 156, Issue 6, pp 31–35

Für welche Patienten die richtige Wahl?

Konservative Therapie der koronaren Herzkrankheit
FORTBILDUNG_SCHWERPUNKT

Im September 2013 veröffentlichte die Europäische Gesellschaft für Kardiologie (ESC) neue Leitlinien zum Management und zur Therapie der stabilen koronaren Herzkrankheit (KHK) [1]. Ein wesentlicher Teil dieser Leitlinie beschäftigt sich damit, Patienten auszuwählen, die für eine konservative Therapie besser geeignet sind als für eine interventionelle Therapie.

Keywords - Medical therapy of coronary artery disease

Angina pectoris stable coronary artery disease medical treatment 

Literatur

  1. 1.
    Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, Bugiardini R, Crea F, Cuisset T, Di Mario C, Ferreira JR, Gersh BJ, Gitt AK, Hulot JS, Marx N, Opie LH, Pfisterer M, Prescott E, Ruschitzka F, Sabaté M, Senior R, Taggart DP, van der Wall EE, Vrints CJ. 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 2013;34(38):2949–3003.PubMedCrossRefGoogle Scholar
  2. 2.
    Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GB, Weintraub WS; COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356(15):1503–1516.PubMedCrossRefGoogle Scholar
  3. 3.
    Henderson RA, O’Flynn N; Guideline Development Group. Management of stable angina: summary of NICE guidance. Heart 2012;98(6):500–507.PubMedCrossRefGoogle Scholar
  4. 4.
    Yusuf S, Wittes J, Friedman L. Overview of results of randomized clinical trials in heart disease. I. Treatments following myocardial infarction. JAMA 1988;260(14):2088–2093.PubMedCrossRefGoogle Scholar
  5. 5.
    Hjalmarson A, Goldstein S, Fagerberg B, Wedel H, Waagstein F, Kjekshus J, Wikstrand J, El Allaf D, Vitovec J, Aldershvile J, Halinen M, Dietz R, Neuhaus KL, Janosi A, Thorgeirsson G, Dunselman PH, Gullestad L, Kuch J, Herlitz J, Rickenbacher P, Ball S, Gottlieb S, Deedwania P. Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in congestive heart failure (MERIT-HF). MERIT-HF Study Group. JAMA 2000;283(10):1295–1302.PubMedCrossRefGoogle Scholar
  6. 6.
    Rehnqvist N, Hjemdahl P, Billing E, Bjorkander I, Eriksson SV, Forslund L, Held C, Nasman P, Wallen NH. Effects of metoprolol vs verapamil in patients with stable angina pectoris. The Angina Prognosis Study in Stockholm (APSIS). Eur Heart J 1996;17(1):76–81. Erratum in: Eur Heart J 1996;17(3):483.PubMedCrossRefGoogle Scholar
  7. 7.
    Nissen SE, Tuzcu EM, Libby P, Thompson PD, Ghali M, Garza D, Berman L, Shi H, Buebendorf E, Topol EJ. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: the CAMELOT study: a randomized controlled trial. JAMA 2004;292(18):2217–2225.PubMedCrossRefGoogle Scholar
  8. 8.
    Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R, investigators B. Heart rate as a prognostic risk factor in patients with coronary artery disease and leftventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet 2008;372(9641):817–821.PubMedCrossRefGoogle Scholar
  9. 9.
    Wilson SR, Scirica BM, Braunwald E, Murphy SA, Karwatowska-Prokopczuk E, Buros JL, Chaitman BR, Morrow DA. Efficacy of ranolazine in patients with chronic angina observations from the randomized, double-blind, placebocontrolled MERLIN-TIMI (Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST-Segment Elevation Acute Coronary Syndromes) 36 Trial. J Am Coll Cardiol 2009;53(17):1510–1516.PubMedCrossRefGoogle Scholar
  10. 10.
    Kosiborod M, Arnold SV, Spertus JA, McGuire DK, Li Y, Yue P, Ben-Yehuda O, Katz A, Jones PG, Olmsted A, Belardinelli L, Chaitman BR. Evaluation of Ranolazine in Patients with Type 2 Diabetes Mellitus and Chronic Stable Angina. Results from the TERISA randomized clinical trial. J Am Coll Cardiol 2013; 61(20):2038–2045PubMedCrossRefGoogle Scholar
  11. 11.
    Wagner F, Gohlke-Barwolf C, Trenk D, Jahnchen E, Roskamm H. Differences in the antiischaemic effects of molsidomine and isosorbide dinitrate (ISDN) during acute and short-term administration in stable angina pectoris. Eur Heart J 1991;12(9):994–999.PubMedGoogle Scholar
  12. 12.
    Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324(7329):71–86. Erratum in BMJ 2002;324(7330):141.Google Scholar
  13. 13.
    Arandomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996;348(9038):1329–1339.Google Scholar
  14. 14.
    Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, Agewall S, Alegria E, Chapman MJ, Durrington P, Erdine S, Halcox J, Hobbs R, Kjekshus J, Filardi PP, Riccardi G, Storey RF, Wood D, Bax J, Vahanian A, Auricchio A, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Filippatos G, Funck-Brentano C, Hasdai D, Hoes A, Kearney P, Knuuti J, Kolh P, McDonagh T, Moulin C, Poldermans D, Popescu BA, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vardas P, Widimsky P, Windecker S, Berkenboom G, De Graaf J, Descamps O, Gotcheva N, Griffith K, Guida GF, Gulec S, Henkin Y, Huber K, Kesaniemi YA, Lekakis J, Manolis AJ, Marques-Vidal P, Masana L, McMurray J, Mendes M, Pagava Z, Pedersen T, Prescott E, Rato Q, Rosano G, Sans S, Stalenhoef A, Tokgozoglu L, Viigimaa M, Wittekoek ME, Zamorano JL. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011;32(14):1769–1818.PubMedCrossRefGoogle Scholar
  15. 15.
    Dahlof B, Sever PS, Poulter NR, Wedel H, Beevers DG, Caulfield M, Collins R, Kjeldsen SE, Kristinsson A, McInnes GT, Mehlsen J, Nieminen M, O’Brien E, Ostergren J. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet 2005;366(9489):895–906.PubMedCrossRefGoogle Scholar
  16. 16.
    Jamerson K, Weber MA, Bakris GL, Dahlof B, Pitt B, Shi V, Hester A, Gupte J, Gatlin M, Velazquez EJ. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Eng J Med 2008;359(23):2417–2428.CrossRefGoogle Scholar
  17. 17.
    Yusuf S, Teo KK, Pogue J, Dyal L, Copland I, Schumacher H, Dagenais G, Sleight P, Anderson C. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Eng J Med 2008;358(15):1547–1559Google Scholar

Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  1. 1.Robert-Bosch-Krankenhaus Zentrum für Innere Medizin, KardiologieStuttgartDeutschland

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