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Sekundärprävention nach Myokardinfarkt

Secondary prevention after myocardial infarction

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Zusammenfassung

Die Sterblichkeit nach akutem Myokardinfarkt hat sich in den letzten Jahren signifikant verringert. Für die verbesserte Prognose in der Frühphase nach Myokardinfarkt sind v. a. die weiterentwickelten pharmakologischen und interventionellen Revaskularisationsverfahren verantwortlich. Für den weiteren Verlauf ist nach der Revaskularisation eine evidenzbasierte Sekundärprävention entscheidend, die neben dem leitliniengerechten Einsatz von Pharmazeutika auch Modifikationen des Lebensstils umfasst. Um arterielle Hypertonie, linksventrikuläres Remodeling und arrhythmogenes Potenzial positiv zu beeinflussen, kommen ACE-Hemmer, Angiotensinrezeptorenblocker und β-Blocker zum Einsatz. CSE-Hemmer senken das LDL- und steigern das HDL-Cholesterin. Acetylsalicylsäure und Clopidogrel werden zur langfristigen Thrombozytenaggregationshemmung eingesetzt. Lebensstiländerungen umfassen eine an mehrfach ungesättigten Fettsäuren reiche Ernährung, moderate körperliche Aktivität, Gewichtsreduktion und Nikotinverzicht.

Abstract

A significant reduction in cardiovascular mortality has been achieved during the last decade. New techniques and materials for early coronary intervention have contributed significantly to reduce early mortality after myocardial infarction. Secondary prevention determines further progress; it combines evidence-based medical treatment as well as lifestyle modifications. ACE inhibitors, angiotensin receptor blockers, and β-blocker positively affect elevated blood pressure, left ventricular remodeling, and electrical stability. Statins decrease LDL and increase HDL cholesterol. Acetylsalicylic acid and clopidogrel are indicated for antiplatelet therapy. Lifestyle modifications unite a diet rich in polyunsaturated fatty acids, moderate physical activity, weight reduction, and smoking cessation.

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  1. Medizinische Klinik 2, Städtisches Klinikum Braunschweig gGmbH, Salzdahlumer Straße 90, 38126, Braunschweig, Deutschland

    J.E. Pflumm, T. Pomykaj &  M.P. Heintzen

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  1. J.E. Pflumm
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  2. T. Pomykaj
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  3. M.P. Heintzen
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Correspondence to M.P. Heintzen.

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Pflumm, J., Pomykaj, T. & Heintzen, M. Sekundärprävention nach Myokardinfarkt. Internist 49, 1052–1060 (2008). https://doi.org/10.1007/s00108-008-2077-0

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