Rationale Therapie bei koronarer Herzkrankheit

  • B. T. Ivandic
  • M. Müller-Bardorff
  • H. A. Katus

Zusammenfassung

Für die Therapie der koronaren Herzkrankheit (KHK) steht eine Fülle von therapeutischen Optionen mit unterschiedlichen Wirkmechanismen zur Verfügung. Der optimale Einsatz dieser Methoden und/oder die Kombination verschiedener therapeutischer Ansätze ist eine wesentliche Aufgabe in der Therapieplanung bei Patienten mit KHK. Eine rationale Therapie muß sowohl auf eine Verlangsamung der Progression der Erkrankung als auch auf eine Reduktion der Häufigkeit ischämischer Ereignisse und auf eine Verlängerung der Überlebenszeit bei erhaltener Lebensqualität zielen. Dies ist durch die Kombination einer allgemeingültigen Basistherapie mit einer am individuellen Risiko ausgerichteten speziellen Therapie erreichbar.

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Literatur

  1. 1.
    Launbjerg J, Fruergaard P, Jacobsen HL, Madsen JK (1995) Long-term risk factors from noninvasive evaluation of patients with acute chest pain, but without myocardial infarction. Eur Heart J 16: 30–37.PubMedCrossRefGoogle Scholar
  2. 2.
    Volpi A, De Vita C, Franzosi MG et al. (1993) Determinants of 6-month mortality in survivors of myocardial infarction after thrombolysis: results of the GISSI–2 data base. Circulation 88: 416–429.PubMedGoogle Scholar
  3. 3.
    Volpi A, De Vita C, Franzosi MG et al. (1994) Predictors of nonfatal reinfarction in survivors of myocardial infarction after thrombolysis: results of the Gruppo Italiano per lo Studio della Sopravivenza nelPlnfarto Miocardico (GISSI-2) data base. J Am Coll Cardiol 24: 608–615.PubMedCrossRefGoogle Scholar
  4. 4.
    Olona M, Candell-Riera J, Permanyer-Miralda G et al. (1995) Strategies for prognostic assess-ment of uncomplicated first myocardial infarction: 5-year follow-up study. J Am Coll Cardiol 25: 815–822.PubMedCrossRefGoogle Scholar
  5. 5.
    Varnauskas E, the European Coronary Surgery Study Group (1988) Twelve-year follow-up of survival in the randomized European Coronary Surgery Study. N Engl J Med 6: 332–337.Google Scholar
  6. 6.
    VA Coronary Artery Bypass Surgery Cooperative Study Group (1992) Eighteen-year follow-up in the Veterans Affairs Cooperative Study of coronary artery bypass surgery for stable angina. Circulation 86: 121–130.Google Scholar
  7. 7.
    Davis KB, Chaitman B, Ryan T, Bittner V, Kennedy W (1995) Comparison of 15-year survival for men and women after initial medical or surgical treatment for coronary artery disease: a CASS registry study.J Am Coll Cardiol 25: 1000–1009.PubMedCrossRefGoogle Scholar
  8. 8.
    Caracciolo EA, Davis KB, Sopko G et al. (1995) Comparison of surgical and medical group survival in patients with left main equivalent coronary artery disease: long-term CASS experience. Circulation 91: 2335–2344.PubMedGoogle Scholar
  9. 9.
    Paffenbarger RS, Hyde RT, Wing AL, Lee I-Min, Jung DL, Kampert JB (1993) The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 328: 538–545.PubMedCrossRefGoogle Scholar
  10. 10.
    Manson JE, Tosteson H, Ridker PM et al. (1992) The primary prevention of myocardial infarc-tion. N Engl J Med 326: 1406–1416.PubMedCrossRefGoogle Scholar
  11. 11.
    Ornish D, Brown SE, Scherwitz LW et al. (1990) Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 336: 129–133.PubMedCrossRefGoogle Scholar
  12. 12.
    Wittemann JCM, Grobbee DE, Valkenburg HA, Hemert AM van, Stijnen T, Hofman A (1993) Cigarette smoking and the development and progression of aortic atherosclerosis: a 9-year population-based follow-up study in women. Circulation 88: 2156–2162.Google Scholar
  13. 13.
    Despres J-P, Lamarche B (1994) Low-intensity endurance exercise training, plasma lipoproteins and the risk of coronary heart disease. J Intern Med 236: 7–22.PubMedCrossRefGoogle Scholar
  14. 14.
    O’Connor GT, Buring JE, Yusuf S, Goldhaber SZ, Olmstead EM, Paffenbarger RS, Hennekens CH (1989) An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 80: 234–244.PubMedCrossRefGoogle Scholar
  15. 15.
    Haskell WL, Alderman EL, Fair JM et al. (1994) Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease: the Stanford Coronary Risk Intervention Project (SCRIP). Circulation 89: 975–990.PubMedGoogle Scholar
  16. 16.
    MAAS investigators (1994) Effect of simvastatin on coronary atheroma: the Multicenter Anti- Atheroma Study (MAAS). Lancet 344: 633–638.CrossRefGoogle Scholar
  17. 17.
    Gould AL, Roussouw JE, Santanello NC, Heyse JF, Furberg CD (1995) Cholesterol reduction yields clinical benefit: a new look at old data. Circulation 91: 2274–2282.PubMedGoogle Scholar
  18. 18.
    Scandinavian Simvastatin Survival Study Group (1994) Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 344: 1383–1389.Google Scholar
  19. 19.
    Shepherd J, Cobbe SM, Ford I et al. (1995) Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 333: 1301–1307.PubMedCrossRefGoogle Scholar
  20. 20.
    Yusuf S, Anand S (1996) Cost of prevention: the case of lipid lowering. Circulation 93: 1774–1776.PubMedGoogle Scholar
  21. 21.
    Falk E, Fuster V (1995) Angina pectoris and disease progression. Circulation 92: 2033–2035.PubMedGoogle Scholar
  22. 22.
    Falk E, Shah PK, Fuster V (1995) Coronary plaque disruption. Circulation 92: 657–671.PubMedGoogle Scholar
  23. 23.
    Patrono C (1994) Aspirin as an antiplatelet drug. N Engl J Med 330: 1287–1294.PubMedCrossRefGoogle Scholar
  24. 24.
    Goldman S, Copeland J, Moritz T et al. (1994) Long-term graft patency (3 years) after coronary artery surgery: effects of aspirin: results of a VA cooperative study. Circulation 89: 1138–1143.PubMedGoogle Scholar
  25. 25.
    Relmari AS (1988) Aspirin for the primary prevention of mycardial infarction. N Engl J Med 318: 245–246.CrossRefGoogle Scholar
  26. 26.
    Peto R, Gray R, Collins R et al. (1988) Randomised trial of prophylactic daily aspirin in bri- tish male doctors. B M J 296: 313–316.CrossRefGoogle Scholar
  27. 27.
    Physicians’ Health Study Research Group, steering commitee (1989) Final report on the aspirin component of the ongoing Physicians’ Health Study. N Engl J Med 321: 129–135.CrossRefGoogle Scholar
  28. 28.
    Lorenz RL, Schacky CV, Weber M et al. (1984) Improved aortocoronary bypass patency by low-dose Aspirin (100 mg daily). Lancet 1 (8389): 1261–1264.PubMedCrossRefGoogle Scholar
  29. 29.
    Meer J van der, Riviere AB de la, Gilst WH van et al. (1994) Effects of low dose aspirin (50 mg/day), low dose aspirin plus dipyridamole, and oral anticoagulant agents after internal mammary artery bypass grafting: patency and clinical outcome at 1 year. J Am Coll Cardiol 24: 1181–1188.PubMedCrossRefGoogle Scholar
  30. 30.
    Ridker PM, Manson JE, Buring JE, Muller JE, Hennekens CH (1990) Circadian variation of acute myocardial infarction and the effect of low-dose aspirin in a randomized trial of physicians. Circulation 82: 897–902.PubMedCrossRefGoogle Scholar
  31. 31.
    Wallentin LC, the Research Group on Instability in Coronary Artery Disease in Southeast Sweden (1991) Aspirin 75 mg/day) after an episode of unstable coronary artery disease: long-term effects on the risks for myocardial infarction, occurence of severe angina and the need for revascularization. J Am Coll Cardiol 18: 1587–1593.CrossRefGoogle Scholar
  32. 32.
    Juul-Moller S, Edvardsson N, Jahnmatz B, Rosen A, Sorensen S, Omblus R (1992) Double- blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet 340: 1421–1425.PubMedCrossRefGoogle Scholar
  33. 33.
    Balsano F, Rizzon P, Violi F et al., the Studio della Ticlopidina nelPAngina Instabile Group (1990) Antiplatelet treatment with ticlopidine in unstable angina: a controlled multicenter clinical trial. Circulation 82: 17–26.CrossRefGoogle Scholar
  34. 34.
    Handin RI (1996) Platelets and coronary artery disease. N Engl J Med 334: 1126–1128.PubMedCrossRefGoogle Scholar
  35. 35.
    Pepine CJ, Abrams J, Marks RG, Morris JJ, Scheidt SS, Handberg E (1994) Characteristics of a contemporary population with angina pectoris. Am J Cardiol 74: 226–231.PubMedCrossRefGoogle Scholar
  36. 36.
    Stone PH, Gibson RS, Glasser SP et al., the ASIS Study Group (1990) Comparison of propranolol, diltiazem, and nifedipine in the treatment of ambulatory ischemia in patients with stable angina: differential effects on ambulatory ischemia, exercise performance, and anginal symptoms. Circulation 82: 1962–1972.CrossRefGoogle Scholar
  37. 37.
    Arnim T von (1995) Medical treatment to reduce total ischemic burden: Total Ischemic Burden Bisoprolol Study (TIBBS), a multicenter trial comparing bisoprolol and nifedipine. J Am Coll Cardiol 25: 231–238.CrossRefGoogle Scholar
  38. 38.
    Rehnqvist N, Hjemdahl P, Billing E et al. (1996) Effects of metoprolol vs. verapamil in patients with stable angina pectoris: the Angina Prognosis Study in Stockholm (APSIS). Eur Heart J 17: 76–81.PubMedGoogle Scholar
  39. 39.
    Fox KM, Mulcahy D, Findlay I, Ford I, Dargie HJ (1996) The total ischaemic burden european trial (TIBET): effects of atenolol, nifedipine SR and their combination on the exercise test and the total ischaemic burden in 608 patients with stable angina. Eur Heart J 17: 96–103.PubMedGoogle Scholar
  40. 40.
    Multicenter Diltiazem Postinfarction Trial Research Group (1988) The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J Med 319: 385–392.CrossRefGoogle Scholar
  41. 41.
    Danish Study Group on Verapamil in Myocardial Infarction (1990) Effect of verapamil on mortality and major events after acute myocardial infarction (the Danish Verapamil Infarction Trial II - DAVIT II) Am J Cardiol 66: 779–785.CrossRefGoogle Scholar
  42. 42.
    Furberg CD, Psaty BM, Meyer JV (1995) Nifedipine: dose-related increase in mortality in patients with coronary heart disease. Circulation 92: 1326–1331.PubMedGoogle Scholar
  43. 43.
    Kloner RA (1995) Nifedipine in ischemic heart disease. Circulation 92: 1074–1078.PubMedGoogle Scholar
  44. 44.
    Yusuf S (1995) Calcium antagonists in coronary artery disease and hypertension: time for revaluation? Circulation 92: 1079–1082.PubMedGoogle Scholar
  45. 45.
    Goldman L, Sia STB, Cook EF, Rutherford JD, Weinstein MC (1988) Costs and effectiveness of routine therapy with long-term beta-adrenergic antagonists after acute myocardial infarction. N Engl J Med 319: 152–157.PubMedCrossRefGoogle Scholar
  46. 46.
    Dahlof C, Dimenas E, Kendall M, Wiklund I (1991) Quality of life in cardiovascular diseases: emphasis on (3-blocker treatment. Circulation 84: VI-108–VI-118.Google Scholar
  47. 47.
    Frishman WH (1992) ß-adrenergic blockers as cardioprotective agents. Am J Cardiol 70: 2 I–6 I.CrossRefGoogle Scholar
  48. 48.
    Kendall MJ, Lynch KP, Hjalmarson A, Kjekshus J (1995) ß -Blockers and sudden cardiac death. Ann intern Med 123: 358–367.PubMedGoogle Scholar
  49. 49.
    CIBIS Investigators and Committees (1994) A randomized trial of ß-blockade in heart failure: the Cardiac Insufficiency Bisoprolol Study (CIBIS). Circulation 90: 1765–1773.Google Scholar
  50. 50.
    Waagstein F, Bristow MR, Swedberg K et al. (1993) Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Lancet 342: 1441–1446.PubMedCrossRefGoogle Scholar
  51. 51.
    Packer M, Bristow M, Cohn JN, Colucci WS, Fowler MB, Gilbert EM, Shusterman NH (1996) The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 334: 1349–1355.PubMedCrossRefGoogle Scholar
  52. 52.
    Pfeffer MA, Stevenson LW (1996) (3-Adrenergic blockers and survival in heart failure. N Engl J Med 334: 1396–1397.PubMedCrossRefGoogle Scholar
  53. 53.
    Lonn EM, Yusuf S, Jha P, Montague TJ, Teo KK, Bendict CR, Pitt B (1994) Emerging role of angiotensin-converting enzyme inhibitors in cardiac and vascular protection. Circulation 90: 2056–2069.PubMedGoogle Scholar
  54. 54.
    Hueb WA, Bellotti G, Almeida de Oliveira S, Arie S, Piva de Albuquerque C, Jatene AD, Pileggi F (1995) The Medicine, Angioplasty or Surgery Study (MASS): a prospective, randomized trial of medical therapy, balloon angioplasty or bypass surgery for single proximal left anterior descending artery stenoses. J Am Coll Cardiol 26: 1600–1605.PubMedCrossRefGoogle Scholar
  55. 55.
    Schlant RC (1995) Coronary angioplasty in patients with stable angina pectoris and one- vessel disease. Circulation 92: 1676–1677.PubMedGoogle Scholar
  56. 56.
    Strauss WE, Fortin T, Hartigan P, Folland ED, Parisi AF, the Veterans Affairs Study of Angio-plasty Compared to Medical Therapy Investigators (1995) A comparison of quality of life scores in patients with angina pectoris after angioplasty compared with after medical therapy: outcomes of a randomized clinical trial. Circulation 92: 1710–1719.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • B. T. Ivandic
  • M. Müller-Bardorff
  • H. A. Katus

There are no affiliations available

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