Akuter Myokardinfarkt

  • Elisabeth von der Lohe


Progredienz der KHK von der stabilen Angina zum Myokardinfarkt Die Grenzen zwischen stabiler und instabiler Angina bis zum Non-QWave- Infarkt sind fließend. Eine stabile Angina tritt bei Vorhandensein einer fixierten Koronararterienstenose auf. Die Progression dieser Stenose bis zum potenziellen kompletten Verschluss und somit zum Myokardinfarkt ist nicht voraussehbar. Allerdings ist bei einer Stenose die Ausbildung von Kollateralgefäßen möglich, was trotz kompletten Gefäßverschlusses ohne Myokardinfarkt verlaufen kann.


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  1. ACE Inhibitor Myocardial Infarction Collaborative Group (1998) Indications for ACE inhibitors in the early treatment of acute myocardial infarction: systemic overview of individual data from 100,000 patients in randomized trials. Circulation 98(19):2202–2212Google Scholar
  2. American Heart Association (1999) Heart and Stroken Statistical Update 1999. American Heart Association, Dallas/TX, vol 11Google Scholar
  3. Becker RC, Terrin M, Ross R et al. (1994) Comparison of clinical outcomes for women and men after acute myocardial infarction. The Thrombolysis in Myocardial Infarction (TIMI-II) Investigators. Ann Intern Med 120:6345 Google Scholar
  4. Beta-Blocker Heart Trial Research Group (1982) A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. JAMA 247:1707–1714Google Scholar
  5. De Jaegere PP, Arnold AA, Balk AH, Simoons ML (1992) Intracranial hemorrhage in association with thrombolytic therapy: incidence and clinical predictive factors. J Am Coll Cardiol 19:289–294PubMedCrossRefGoogle Scholar
  6. Demirovic J, Blackburn H, McGovern PG, Luepker R, Sprafka JM, Gilbertson D (1995) Sex differences in early mortality after acute myocardial infarction (the Minnesota Heart Survey). Am J Cardiol 75:1096–1101PubMedCrossRefGoogle Scholar
  7. Dittrich H, Gilpin E, Nicod P, Cali G, Henning H, Ross J jr (1988) Acute myocardial infarction in women: influence of gen der on mortality and prognostic variables. Am J Cardiol 62:1–7PubMedCrossRefGoogle Scholar
  8. Fiebach NH, Viscoli CM, Horwitz RI (1990) Differences between women and men in survival after myocardial infarction. Biology or methodology? JAMA 236:1092–1096CrossRefGoogle Scholar
  9. FRESCO-Trial: Antoniucci D, Santoro GM, Bolognese L et al. (1998) A clinical trial comparing primary stenting of the infarct-related artery with oprimal primary angioplasty for acute myocardial infarction. Results from the florence randomized elective stenting in acute coronary occlusions (Fresco) trial. J Am Coll Cardiobl 31:496–501Google Scholar
  10. Funk M, Griffey KA (1992) Relation of gender to the use of cardiac procedures in acute myocardial infarction. Am J Cardiol 74:1170–1173CrossRefGoogle Scholar
  11. Fuster V, Badimon L, Badimon JJ, Chesebro JH (1992) The pathogenesis of coronary artery disease and the acute coronary syndromes. N Engl J Med 326:310–318PubMedCrossRefGoogle Scholar
  12. Goldberg RJ, Gorak EJ, Yarzebski J et al. (1993) A community-wide perspective of sex differences and temporal trends in the incidence and survival rates after acute myocardial infarction and out-of-hospital deaths caused by coronary heart disease. Circulation 87:1947–1953PubMedCrossRefGoogle Scholar
  13. Greenland P, Reicher-Reiss H, Goldbourt U, Behar S (1991) In-hospital and 1-year-mortality in 1,524 women after myocardial infarction: comparison with 4,315 men. Circulation 83:484–491PubMedCrossRefGoogle Scholar
  14. Grines Cl, Browne KF, Marco J et al. (1993) A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. The Primary Angioplasty in Myocardial Study Group. N Engl J Med 328:673–679PubMedCrossRefGoogle Scholar
  15. Gruppo Italiano per 10 Studio della Streptochinasi nell’Infarto Miocardico (GISSI) (1986) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1:397–401Google Scholar
  16. Gurwitz JH, McLaughlin TJ, Willison DJ et al. (1997) Delayed hospital presentation in patients who have had acute myocardial infarction. Ann Intern Med 126:593–599PubMedGoogle Scholar
  17. Harpaz D, Benderly M, Goldbourt U et al. (1996) Effect of aspirin on mortality in women with symptomatic or silent myocardial ischemia. Israeli BIP Study Group. Am J Cardiol 78:1215–1219PubMedCrossRefGoogle Scholar
  18. Held PH, Yusuf S, Furberg CD (1989) Calcium channel blockers in acute myocardial infarction and unstable angina: an overview. BMJ 299:1187–1192PubMedCrossRefGoogle Scholar
  19. Hochman JS, McCabe CH, Stone PH et al. (1997) Outcome and profile of women and men presenting with acute coronary syndromes: a report from TIMI IIIB. Thrombolysis in Myocardial Infarction (TIMI) Investigators. J Am Coll Cardiol 30:141–181PubMedCrossRefGoogle Scholar
  20. ISIS-1 Collaborative Group (1986) Randomized trial of intravenous atenolol among 16,027 cases of suspected acute myocardial infarction. Lancet 2:57–67Google Scholar
  21. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group (1988) Randomised trial of intravenous streptokinase, oral aspirin, both or neither among 17,187 cases of suspected acute myocardial infarction. ISIS-2. Lancet 2:349–260Google Scholar
  22. ISIS-2 Collaborative Group (1987) Randomized factorial trial of high-dose intravenous streptokinase, of oral aspirin and of intravenous heparin in acute myocardial infarction. ISIS (International Studies of Infarct Survival) pilot study. Eur Heart J 8:634–642Google Scholar
  23. Jenkins JS, Fiaker GC, Nolte B et al. (1994) Causes of higher in-hospital mortality in women than in men after acute myocardial infarction. Am J Cardiol 73:319–322PubMedCrossRefGoogle Scholar
  24. Kannel WB, Abbott RD (1984) Incidence and prognosis of unrecognized myocardial infarction: an update on the Framingham study. N Engl J Med 311:1144–1147PubMedCrossRefGoogle Scholar
  25. Kannel WB, Soriie P, McNamara PM (1979) Prognosis after initial myocardial infarction: the Framingham Study. Am J Cardiol 44:53–59PubMedCrossRefGoogle Scholar
  26. Karlson BW, Herlitz J, Hartford M (1994) Prognosis in myocardial infarction in relation to gender. Am Heart J 128:477–483PubMedCrossRefGoogle Scholar
  27. Koenig W, Lowel H, Lewis M, Hormann A (1996) Long-term survival after myocardial infarction: relationship with thrombolysis and discharge medication: results of the Augsburg Myocardial Infarction Follow-up Study 1985-1993. Eur Heat J. 17:1199–1206CrossRefGoogle Scholar
  28. Kornowski R, Goldbourt U, Boyko V, Behar S (1995) Clinical predictors of reinfarction among men and women after a first myocardial infarction. Secondary Prevention Israeli Reinfarction Nifedipine Trial (SPRINT) Study Group. Cardiology 86:163–168PubMedCrossRefGoogle Scholar
  29. Kostis JB, Wilson AC, O’Dowd K et al. (1994) Sex differences in the management and long-term outcome of acute myocardial infarction.A statewide study. MIDAS Study Group. Myocardial Infarction Data Acquisition system. Circulation 90:1715–1730Google Scholar
  30. Libby P (1995) Molecular bases of the acute coronary syndromes. Circulation 91:2844–2850PubMedCrossRefGoogle Scholar
  31. Lincoff AM, Califf RM, Ellis SG et al. (1993) Thrombolytic therapy for women with myocardial infarction: is there a gender gap? Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group. J Am Coll Cardiol 22:1780–1787PubMedCrossRefGoogle Scholar
  32. Maggioni AP, Franzosi MG, Santoro E et al. (1992) The risk of stroke inpatient with acute myocardial infarction after thrombolytic and antithrombotic treatment. Gruppo Italiano per 10 Studio della Sopravvivenza nell’Infarto Miocardieo II (GISSI-2) and the International StudyGroup. N Engl J Med 327:1–6PubMedCrossRefGoogle Scholar
  33. Malacrida R, Genoni M, Maggioni AP et al. (1998) A comparison of the early outcome of acute myocardial infarction in women and men. N Engl J Med 338:8–14PubMedCrossRefGoogle Scholar
  34. Marrugat J, Anto JM, Sala J, Masia R (1994) Influence of gender in acute and long-term cardiac mortality after a first myocardial infarction. REGICOR Investigators. J Clin Epidemiol 47:111–118PubMedCrossRefGoogle Scholar
  35. Maynard C, Litwin PE, Martin JS, Weaver WD (1992) Gender differences in the treatment and outcome of acute myocardial infarction: results from the Myocardial Infarction Triage and Intervention (MITI) Registry.Arch Intern Med 152:972–976PubMedCrossRefGoogle Scholar
  36. Meischke H, Eisenberg MS, Larsen MP (1993) Prehospital delay interval for patients who use emergency medical serviees: the effect of heart related me die al conditions and demographie variables.Ann Emerg Med 22:1597–1601PubMedCrossRefGoogle Scholar
  37. Moen EK, Asher CR, Miller DP et al. (1997) Long-term follow-up of genderspecific outcomes after thrombolytic therapy for acute myocardial infarction from the GUSTO-I Trial. J Womens Health 6:285–293PubMedCrossRefGoogle Scholar
  38. Murabito JM, Evans JC, Larson MG, Levy D (1993) Prognosis after the onset of coronary artery disease. An investigation of differences in outcome between the sexes according to initial coronary disease presentation. Circulation 88:2548–2555PubMedCrossRefGoogle Scholar
  39. Pfeffer MA, Braunwald E, Moye LA et al. (1992) Effect of captopril on mortality and morbidity in patients with left ventrieular dysfunction after myocardiaI infarction: results of the Survival and Ventricular Enlargement Trail. The SAVE Investogators. N Engl J Med 327:669–677PubMedCrossRefGoogle Scholar
  40. Puletti M, Sunseri L, Curione M et al. (1984) Acute myocardiaI infarction: sexrelated differences in prognosis. Am Heart J 108:63–66PubMedCrossRefGoogle Scholar
  41. Robinson K, Conroy RM, Mulcahy R, Hiekey N (1988) Risk factors and inhospital course of first episode of myocardial infarction or acute coronary insufficiency in women. J Am Coll Cardiol 11:932–936PubMedCrossRefGoogle Scholar
  42. Rodda BE (1983) The Timolol Myocardial Infarction Study: an evaluation of selected variables. Circulation 67:1101–1106Google Scholar
  43. Savage MP, Krolewski AS, Kenien GG et al. (1988) Acute myocardial infarction in diabetes mellitus and significance of congestive heart failure as a prognostie factor. Am J Cardiol 62:665–669PubMedCrossRefGoogle Scholar
  44. Schmidt SB, Borsch MA (1990) The prehospital phase of acute myocardial infarction in the era of thrombolysis. Am J Cardiol 65:1411–1415PubMedCrossRefGoogle Scholar
  45. Schunkert H, Danser AH, Hense HW et al. (1997) Effects of estrogen replacement therapyon the renin-angiotensin system in post-menopausaI women. Circulation 95:39–45PubMedCrossRefGoogle Scholar
  46. Smith JW, Marcus PI, Serokman R (1984) Prognosis of patient with diabetes mellitus after acute myocardial infarction. Am J Cardiol 54:718–721PubMedCrossRefGoogle Scholar
  47. Steingart RM, Packer M, Hamm P et al. (1991) Sex differences in the management of coronary artery disease. Survival and Ventricular Enlargement (SAVE) Investigators. N Engl J Med 325:226–230PubMedCrossRefGoogle Scholar
  48. Stone Gw, Grines Cl, Browne KF et al. (1995) Comparison of in-hospital outcome in men versus women treated by either thrombolytic therapy or primary angioplasty for acute myocardial infarction. American Journal of Cardiology 75:987–992PubMedCrossRefGoogle Scholar
  49. Stone PH, Muller JE, Hartwell T et al. (1989) The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and diastolic left ventricular dysfunction to the adverse prognosis. The MILIS Study Group. J Am Coll Cardiol 14:49–57PubMedCrossRefGoogle Scholar
  50. Suryapranata H, van’t Hof AWJ, Hoorntje JCA et al. (1998) Randomized comparison of coronary stenting with balloon angioplasty in selected patients with acute myocardial infarction. Circulation 97:2502–2505PubMedCrossRefGoogle Scholar
  51. Vaccarino V, Krumholz HM, Berkman LF, Horwitz RI (1995) Sex differences in mortality after myocardial infarction: is there evidence for an increased risk for women? Circulation 91:1861–1871PubMedCrossRefGoogle Scholar
  52. Vaccarino V, Parsons L, Every NR et al. (1999) for the National Registry of Myocardial Infarction 2 Participants. Sex-Based Oifferences in early Mortality after Myocardial Infarction. N Engl J Med 341:217–225PubMedCrossRefGoogle Scholar
  53. Weaver WO, White HO, Wilcox RG et al. (1996) Comparisons of characteristics and outcomes among women and men with acute myocardial infarction treated with thrombolytic therapy. GUSTO-I Investigators. JAMA 275:777–782PubMedCrossRefGoogle Scholar
  54. White HO, Barbash GI, Modan M et al. (1993) After correcting the worse baseline characteristics, women treated with thrombolytic therapy for acute myocardial infarction have the same mortality and morbidity as men except for a higher incidence of hemorrhagic stroke. The Investigators of the International Tissue Plasminogen Activator/ Streptokinase Mortality Study. Circulation. 1993;88:2097–103PubMedCrossRefGoogle Scholar
  55. Wilcox RG, von der Lippe G, Olsson CG et al. (1988) Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction. AngloScandinavian Study of Early Thrombolysis (ASSET). Lancet 2:525–530PubMedCrossRefGoogle Scholar
  56. Wilkinson P, Laji K, Ranjadayalan K, parsons L, Timmis AO (1994) Acute myocardial infarction in women: survival analysis in first six months. Br Med J 309:566–569CrossRefGoogle Scholar
  57. Woodfield SL, Lundergan CF, Reiner JS et al. (1997) Gender and acute myocardial infarction: is there a different response to thrombolysis? J Am Coll Cardiol 29:35–42PubMedCrossRefGoogle Scholar
  58. Zuanetti G, Latini R, Maggioni AP et al. (1993) Influence of diabetes on mortality in acute myocardial infarction: data from the GISSI-2 study. J Am Coll Cardiol 22:1788–1794PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2002

Authors and Affiliations

  • Elisabeth von der Lohe
    • 1
  1. 1.Wishard Health ServicesKrannert Institute of CardiologyIndianapolisUSA

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