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Therapie des akuten Myokardinfarktes mit Thrombolyse und PTCA

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Therapie der koronaren Herzerkrankung

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Zusammenfassung

Die Bedeutung der koronaren Herzkrankheit (KHK) in der Bundesrepublik Deutschland ergibt sich aus ihrem Stellenwert in der Todesursachenstatistik. Sie besetzt mit 21% aller Todesfälle bei Männern und 16% bei Frauen den ersten Platz. Obwohl 47% der Männer und 69% der Frauen älter als 75 Jahre sind, ist die KHK auch vor Erreichen des 75. Lebensjahrs bei 23% der männlichen und 21% der weiblichen Verstorbenen als Todesursache ausgewiesen. Nach Angaben des Augsburger Herzinfarktregisters (Löwel et al. 1985) erkrankten durchschnittlich 444 Männer und 138 Frauen je 100 000 der Bevölkerung im Verlauf des Kalenderjahres 1985 an einem Herzinfarkt. Die 28-Tage- Letalität betrug bei den Männern 54% und bei den Frauen 66%. Insgesamt verstarben 34% der Erkrankten ohne in Krankenhausbehandlung gelangt zu sein (Abb. 1). Bei jedem 2. Verstorbenen war ein medizinischer Laie gegenwärtig und bei jedem 3. wurden notärztliche Reanimationsversuche unternommen.

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Literatur

  • AIMS Trial Study Group (1988) Effect of intavenous APSAC on mortality after acute myocardial infarction: preliminary report of a placebo-controlled clinical trial. Lancet 11: 441–446

    Google Scholar 

  • Anderson JL, Rothbard RL, Hackworthy RA et al. (1988) Multicenter reperfusion trial of intravenous anisoylated plasminogen streptokinase activator complex (APSAC) in acute myocardial infarction: controlled comparison with intracoronary streptokinase. J Am Coll Cardiol 11: 1153–1163

    Article  PubMed  CAS  Google Scholar 

  • Braunwald E (1989) Myocardial reperfusion, limitation of infarct size, reduction of left ventricular dysfunction, and improved survival. Should the paradigm be expanded? Circulation 79/2: 441–444

    Article  PubMed  CAS  Google Scholar 

  • Chesebro JH, Knatterud G, Roberts R et al. (1987) Thrombolysis in myocardial infarction (TIMI) trial, phase I: a comparison between intravenous tissue plasminogen activator and intravenous streptokinse. Clinical findings through hospital discharge. Circulation 76/ 1: 142–154

    Article  PubMed  CAS  Google Scholar 

  • Falk E (1983) Plaque rupture with severe pre-existing stenosis precipitating coronary thrombosis. Br Heart J 50: 127–134

    Article  PubMed  CAS  Google Scholar 

  • Ganz W, Geft I, Maddahi J, Berman D, Charuzi Y, Shah PK, Swan HJC (1983) Nonsurgical reperfusion in evolving myocardial infarction. J Am Coll Cardiol 1: 1247–1250

    Article  PubMed  CAS  Google Scholar 

  • GISSI: Gruppo italiano per lo studio della streptochinasi nell infarto miocardico (1986) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 8478: 397–401

    Google Scholar 

  • Gold HK, Leinbach RC, Garabedian HD, Yasuda T, Johns JA, Grossbard EB, Palacios I, Collen D (1986) Acute coronary reocclusion after thrombolysis with recombinant human tissue-type plasminogen activator: prevention by a maintenance infusion. Circulation 73,2: 347–352

    Article  PubMed  CAS  Google Scholar 

  • Harrison DG, Ferguson DW, Collins SM, Skorton DJ, Ericksen EE, Koschos JM, Marcus ML, White CW (1984) Rethrombosis after reperfusion with streptokinase: importance of geometry of residual lesions. Circulation 69: 991–996

    Article  PubMed  CAS  Google Scholar 

  • Hugenholtz PG, Serruys PW, Simoons ML, Lubsen J (196) Thrombolytic therapy for acute coronary obstruction: Status in 1986. Texas Heart Inst J 13: 433–445

    Google Scholar 

  • ISAM Study Group (1986) A prospective trial of intravenous streptokinase in acute myocardial infarction (I.S.A.M.). Mortality, morbidity and infarct size at 21 days. N Engl J Med 314: 1465–1471

    Article  Google Scholar 

  • ISIS-2 (Second International Study of Infarct Survival) Collaborative Group (1988) Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 8607: 349–360

    Google Scholar 

  • Kennedy JW, Ritchie JL, Davis KB, Stadius ML, Maynard C, Fritz JK (1985) The Western Washington randomized trial of intracoronary streptokinase in acute myocardial infarction. N Engl J Med 309: 1477–1482

    Article  Google Scholar 

  • Löwel H, Lewis M, Keil U, Koenig W, Hormann A, Boite HD, Gostomzyk J (1988) Zur Herzinfarktsituation in einer süddeutschen Bevölkerung: Ergebnisse des Augsburger Herzinfarktregisters 1985. Z Kardiol 77: 481–489

    PubMed  Google Scholar 

  • Mathey DG, Schofer J, Sheehan FH, Becher H, Tilsner V, Dodge HT (1985) Intravenous urokinase in acute myocardial infarction. Am J Cardiol 55: 878–882

    Article  PubMed  CAS  Google Scholar 

  • Meyer J, Merx W, Dörr R, Lambertz H, Bethge C, Effert S (1982) Successful treatment of acute myocardial infarction shock by combined percutaneous transluminal coronary recanalization (PTCR) and percutaneous transluminal coronary angioplasty (PTCA). Am Heart J 103: 132–136

    Article  PubMed  CAS  Google Scholar 

  • Neuhaus KL, Tebbe U, Sauer G, Kreuzer H, Kostering H (1983) High dose intravenous streptokinase in acute myocardial infarction. Clin Cardiol 6: 426–430

    Article  PubMed  CAS  Google Scholar 

  • Neuhaus KL, Tebbe U, Gottwik M et al. (1988) Intravenous recombinant tissue plasminogen activator (rt-PA) and urokinase in acute myocardial infarction: Results of the German Activator Urokinase Study (GAUS). J Am Coll Cardiol 12: 581–587

    PubMed  CAS  Google Scholar 

  • Reimer KA, Lowe JE, Rasmussen MM, Jennings W (1977) The wavefront phenomen of ischemic cell death. Circulation 56: 786–794

    PubMed  CAS  Google Scholar 

  • Rentrop P, Blanke H, Köstering K, Karsch KR (1980) Intrakoronare Streptokinase Applikation beim akuten Infarkt und instabiler Angina pectoris. Dtsch Med Wochenschr 105: 221–228

    Article  PubMed  CAS  Google Scholar 

  • Rentrop P, Blanke H, Karsch KR et al. (1981) Changes in left ventricular function after intracoronary streptokinase infusion in clinically evolving myocardial infarction. Am Heart J 102: 1188–1192

    Article  PubMed  CAS  Google Scholar 

  • Rogers WJ, Mantle JA, Hood WP, Baxley WA, Whitlow PL, Reevers RC, Soto B (1983) Prospective randomized trial of intravenous and intracoronary streptokinase in acute myocardial infarction. Circulation 68: 1051–1054

    Article  PubMed  CAS  Google Scholar 

  • Rutsch W, Schartl M, Mathey D et al. (1982) Perkutane, transluminale koronare Rekanalisation: Methodik, Ergebnisse und Komplikationen. Z Kardiol 71: 7–12

    PubMed  CAS  Google Scholar 

  • Schröder R, Biamino G, Leitner ER von, Linderer T, Bruggemann T, Heitz J, Vohringer HF, Wegscheider K (1983) Intravenous short-term infusion of streptokinase in acute myocardial infarction. Circulation 76: 536–541

    Article  Google Scholar 

  • Serruys PW, Wijns W, Brand M van den et al. (1983) Is transluminal coronary angioplasty mandatory after successful thrombolysis? Quantitative coronary angiography study. Br Heart J 50: 257–261

    Article  PubMed  CAS  Google Scholar 

  • Serruys PW, Simoons ML, Suryapranata H et al. (1985) Preservation of global and regional left ventricular function after early thrombolysis in acute myocardial infarction. J Am Coll Cardiol 7: 729–742

    Article  Google Scholar 

  • Simoons ML, Serruys PW, Brand M et al. (1985) Improved survival after early thrombolysis in acute myocardial infarction. A randomized trial by the Interuniversity Cardiology Institute in the Netherlands. Lancet 11: 578–581

    Article  Google Scholar 

  • Simoons ML, Arnold AER, Betriu A et al. (1988) Thrombolysis with tissue plasminogen activator in acute moycardial infarction: no additional benefit from immediate percutaneous coronary angioplasty. Lancet 8579: 197–202

    Article  Google Scholar 

  • Spann JF, Sherry S, Carabello BA et al. (1984) Coronary thrombolysis by intravenous streptokinase in acute myocardial infarction: acute and follow-up studies. Am J Cardiol 53: 655–660

    Article  PubMed  CAS  Google Scholar 

  • TIMI: The thrombolysis in myocardial infarction trial (1985) Phase I findings. N Engl J Med 312: 932–936

    Google Scholar 

  • The TIMI Study Group (1989) Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction. Results of the thrombolysis in myocardial infarction (TIMI) phase II trial. N. Engl J Med 320: 618–627

    Article  Google Scholar 

  • Topol EJ, Califf RM, George BS et al. (1988) A randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction. N Engl J Med 317: 581–588

    Article  Google Scholar 

  • Verstraete M, Bleifeld W, Brower RW et al. (1985 a) Double-blind randomised trial of intravenous tissue-type plasminogen activator versus placebo in acute myocardial infarction. Lancet 11: 965–969

    Article  Google Scholar 

  • Verstraete M, Bernard R, Bory M et al. (1985 b) Randomised trial of intravenous recombinant tissue-type plasminogen activator versus intravenous streptokinase in acute myocardial infarction. Lancet 1: 842–847

    Article  PubMed  CAS  Google Scholar 

  • Verstraete M, Arnold AER, Brower RW et al. (1987) Acute coronary thrombolysis with recombinant human tissue-type plasminogen activator: initial patency and influence of maintained infusion on reocclusion rate. Am J Cardiol 60: 231–237

    Article  PubMed  CAS  Google Scholar 

  • Yusuf S, Collins R, Peto R, Furberg C, Stampfer MJ, Goldhaber SZ, Hennekes CH (1985) Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: overview of results on mortality, reinfarction and side effects from 33 randomized controlled trials. Eur Heart J 6: 556–585

    PubMed  CAS  Google Scholar 

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Authors
  1. W. Rutsch
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  2. H. Schmutzler
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Editors and Affiliations

  1. Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum, Lothstr. 11, D-8000, München 2, Deutschland

    W. Rudolph

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© 1990 Springer-Verlag, Berlin Heidelberg New York

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Rutsch, W., Schmutzler, H. (1990). Therapie des akuten Myokardinfarktes mit Thrombolyse und PTCA. In: Rudolph, W. (eds) Therapie der koronaren Herzerkrankung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-75318-3_8

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  • DOI: https://doi.org/10.1007/978-3-642-75318-3_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-52032-0

  • Online ISBN: 978-3-642-75318-3

  • eBook Packages: Springer Book Archive

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