Zusammenfassung
Die kurative Kardiologie, insbesondere die invasive, interventionelle, hat in den letzten 20 Jahren ungeahnte Erfolge gezeigt. So konnte durch die Einführung der Bypasschirurgie Ende der 60er Jahre und ihre weitere Entwicklung in den 70er Jahren bei einer Großzahl von Patienten mit schwerer Angina pectoris die Lebensqualität und Arbeitsfähigkeit zurückgewonnen und auch das Leben mindestens über die nächsten zehn Jahre sowohl bei stabiler wie unstabiler Angina verlängert werden (27). Das gleiche gilt bis zu einem gewissen Grad auch für die von Grüntzig Ende der 70er Jahre eingeführte Ballondilatation (13), obwohl hier Langzeitresultate bezüglich der Lebensverlängerung noch weitgehend fehlen (14). Aber auch die Entwicklung neuer antianginöser Medikamente, vor allem der Betablocker und Kalziumantagonisten, sowie der oral zu verabreichenden Langzeitnitrate und deren Einführung zur prophylaktischen Behandlung der Angina pectoris bzw. der kardialen Ischämie hat die Lebensqualität der Patienten mit Angina pectoris bzw. koronarer Herzkrankheit entscheidend verbessert (26). Leider haben aber diese kurativen Maßnahmen die Inzidenz der Krankheit, welche — zumindest mit zunehmendem Alter — die überwiegende Mehrheit der Menschen der westlichen Zivilisationsländer in irgendeiner Form befällt, nicht entscheidend gesenkt.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
Literatur
Ambrose JA, Tannenbaum MA, Alexopoulos D, Hjemdahl-Monsen CE, Leavy J, Weiss M, Purriko S, Gorlin R, Fuster V (1988) Angiographic progression of coronary artery disease and the development of myocardial infarction. JACC 12: 56–62
Blankenhorn H, Nessim SA, Johnson RL, Sanmarco ME, Azen SP (1987) Beneficial effects of combined cholestipol-niazin therapy on coronary atherosclerosis and coronary venous bypass grafts. JAMA; 257: 3233–3240
Brett AS (1989) Treating hypercholesterolemia. How should practising physicians interprete the published data for patients? New Engl J Med; 321: 676–680
Buchwald W, Varco RL, Matz JP et al. (1990) Effect of partial illeal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. Report of the program on the surgical control of the hyperlipidemias ( POSCH ). N Engl J Med; 323: 946–955
Buring JE, Hennecken Ch (1990) Meta-analysis of trials of aspirine in cardiovascular disease. Atherosclerosis Review; 21: 145–150
CASS (1984) Principle Investigators and their associates. Myocardial infarction and mortality in the coronary artery surgery study (CASS) randomized trial. N Engl J Med; 310: 750–758
Castelli WP, Garrison RJ, Wilson PW, Abbott RD, Kalousdian S, Kannel W (1986) Incidence of coronary artery disease and lipoprotein cholesterol levels: The Framingham Study. JAMA 256: 2835–2838
Davies MJ (1990) A macro-and microview of coronary vascular insult in ischemic heart disease. Circulation 82 (Suppl II): II-38 -II-46
Fagiotto A (1991) Therapy of atherosclerosis: when? In: Lichtlen PR, Reale A (eds) Adalat, a comprehensive review; Springer, Berlin Heidelberg New York, pp 169–179
Fagiotto A, Ross R, Harker L (1984) Studies of hypercholesterolemia in the non-human primate. Part I and part II. Arteriosclerosis 4: 323–341
Gottlieb SO, Brinker JA, Mellits ED, Achuff StC, Baugham KL, Traill TA, Weiss JL, Reitz BA, Weisfeldt ML, Gerstenblith C (1988) Effect of nifedipine on the development of coronary bypass graft stenoses in high risk patients: a randomized, double-blind-placebo-controlled trial. Circulation (Suppl II): II - 228
Gotto AM, Larosa JC, Hunninghacke D, Grundy SM, Wilson PW, Clarkson TB, Hay JW, Goodman DS (1990) The task force on cholesterol issues, American Heart Association. The cholesterol fact, a summary of the evidence relating dietary fats, serum cholesterol and coronary heart disease. Circulation; 81: 1721–33
Grüntzig AR, Senning A, Siegenthaler WE (1979) Non-operative dilation of coronary artery stenosis: percutaneous transluminal angioplasty. New Engl J Med 301: 61–68
Grüntzig AR, King SB, Schlumpf M, Siegenthaler W (1987) Long-term follow-up after acute perctaneous transluminal coronary angioplasty, the early Zurich experience. New Engl J Med 316: 1127–32
Hackett D, Davies G, Maseri A (1988) Preexisting coronary stenoses in patients with first myocardial infarction are not necessarily severe. Eur Heart J; 9: 1317–1323
Henry PD, Bentley K (1981) Suppression of atherosclerosis in cholesterol-fed rabbits treated with nifedipine. J Clin Invest; 68: 1366–69
Henry PD (1990) Calcium channel blockers and progression of coronary artery disease. Circulation; 82: 2251–53
Henry PD (1990) Antiatherogenic effects of calcium channel blockers: possible mechanisms of action. Cardiovasc Drugs Ther; 4: 1015–1020
Holmes DR, Vliestra RE, Smith HC, Vetrovech GW, Kent KM (1984) Restenosis after PTCA: a report from the PTCA registry of the NHLB-institute. Am J Cardiol; 53: 77C
ISIS-II (1988) Second International Study of Infarct Survival. Collaborative Group. Randomized trial of intravenous streptokinase, oral aspirine, both or neither among 17187 cases of suspected acute myocardial infarctions. Lancet; ISIS-II: 349–63
Jost St, Deckers J, Nellessen U, Rafflenbeul W, Hecker H, Reiber JHC, Hugenholtz PG, Lichtlen PR and the INTACT study group (1988) Clinical application of quantitative coronary angiography using the CAAS system — preliminary results of the INTACT study. Int J Cardiac Imag; 3: 75–86
Kannel WB, Feinleib M (1972) Natural history of angina pectoris in the Framingham study. Prognosis and survival. Am J Cardiol 29: 154
Krayenbühl HP, Hirzel H, Hess OM, Schneider J, Turina M (1987) Hemodynamics of painless ischemia. In: von Arnim T, Maseri A (eds) Silent ischemia, Steinkopff, Darmstadt, pp 128–132
Leaf A. (1988) Management of hypercholesterolemia. Are preventive interventions advisable? New Engl J Med; 321: 680–84
Leimgruber PP et al. (1986) Restenosis after successful coronary angioplasty in patients with single vessel disease. Circulation; 73: 710–717
Lichtlen PR (1988) The combination of antianginal drugs: effects and indications. Cardiovasc Drug Ther 2: 47–60
Lichtlen PR (1990) Koronarangiographie and Koronarchirurgie. In: Lichtlen P (Hrsg) Koronarangiographie, 2. Auflage. Perimed, S 538–582
Lichtlen PR, Hugenholtz PG, Rafflenbeul W, Hecker H, Jost St, Deckers JW and the INTACT group (1990) Retardation of angiographic progression of coronary artery disease by nifedipine. Lancet 335: 1009–1013
Lichtlen PR (1991) Medikamentöse Prävention der Koronarsklerose. Schw Med Wschr, in Vorher.
Lichtlen PR, Nikutta P, Jost St, Rafflenbeul W, Wiese B, and the INTACT study group. Anatomical progression of coronary artery disease in man, as seen by prospective, repeated, quantitatied coronary angiography; relation to clinical events and risk factors. In prep.
Lichtlen PR (1990) Perkutane transluminale koronare Angioplastie (PTCA, Ballondilatation). In: Lichtlen PR (Hrsg) Koronarangiographie, 2. überarbeitete Auflage. Perimed, Erlangen, S 583–648
Loaldi A, Polesi A, Montorsi P, De Cesari N, Fabiocci F, Ravagnani P, Guazzi MD (1989) Comparison of nifedipine, propranolol and isosorbide dinitrate on angiographic progression and regression of coronary artery narrowings in angina pectoris. Am J Cardiol 64: 433–439
Löwel H, Leweis M, Keil U, Koenig W, Hörmann A, Bolte HD, Gostomzyk J (1988) Zur Herzinfarktsituation in einer süddeutschen Bevölkerung. Ergebnisse des Augsburger Herzinfarktregisters 1986. Z Kardiol 77: 481–89
Mathur VS, Guinn GA (1979) Long-term follow-up (4–7 year) of a prospective randomized study to evaluate surgical versus medical treatment for stable angina pectoris: clinical status, exercise performance and survival. Am J Cardiol; 43: 382
Multiple Risk Factor Intervention Trial Research Group (1990) Multiple risk factor intervention trial. JAMA; 263: 1795–1801
Nikutta P, Jost St, Wiese B, Hecker H, Deckers J, Rafflenbeul W, Hugenholtz PG, Lichtlen PR and die INTACT-Gruppe (1991) Koronare Herzkrankheit: Ist die Entwicklung eines Koronararterienverschlusses vorhersehbar? Z Kardiol; ( Suppl III ): 116
Parthasarathy S, Young SG, Witztum JL, Pittmann RC. Steinberg D (1986) Probucol inhibits oxidative modification of low-density lipoprotein. J Clin Invest; 77: 641–644
Schmitz G, Hankowitz J, Kovacs EM (1991) Potential biochemical mechanisms of the antiatherogenic properties of calcium antagonists. In: Lichtlen PR, Reale A (eds) Adalat, a comprehensive review. Springer, Berlin Heidelberg New York, pp 180–196
Schröder R (1989) Thrombolyse bei akutem Myokardinfarkt: eine Standortbestimmung 1988. Z Kardiol 78: 41–62
Simon R, Amende I, Herrmann G (1986) Late angiographic results after successful coronary angioplasty. Circulation 74 (Suppl II): 124
The Veteran’s Administration Coronary Artery Bypass Surgery Cooperative Study Group. 11 years survival in the veteran’s administration randomized trial of coronary bypass surgery for stable angina. N Engl J Med 1984; 311: 1333–1339
Varnauskas E (1988) The European Surgery Group. 12 year follow-up of survival in the randomized European coronary surgery study. N Engl J Med 319: 332–337
Waters D, Lespérance J, Francetick M, Kosey D, Théroux P, Chiang JD, Houdon G, Lemarbre M, Reitman M, Joyal M, Gosselin G, Dyrda I, Macer J, Havel J (1990) A controlled clinical trial to assess the effect of a calcium channel blocker on the progression of coronary atherosclerosis. Circulation; 82: 1049–53
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Lichtlen, P.R. (1991). Ungelöste Aufgaben der kurativen Kardiologie: Stand 1991. In: Gleichmann, U., Mannebach, H., Gleichmann, S., Held, K. (eds) Herausforderung Atherosklerose in den 90ern. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-53795-0_20
Download citation
DOI: https://doi.org/10.1007/978-3-642-53795-0_20
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-642-53796-7
Online ISBN: 978-3-642-53795-0
eBook Packages: Springer Book Archive