Skip to main content
SpringerLink
Log in
Book cover

Die Anästhesiologie pp 1–17Cite as

Anästhesie bei Patienten mit koronarer Herzkrankheit (KHK)

  • Living reference work entry
  • First Online:

  • 428 Accesses

Part of the book series: Springer Reference Medizin ((SRM))

Zusammenfassung

Die koronare Herzkrankheit (KHK) betrifft etwa 5–7 % der Bevölkerung westlicher Industrienationen und ist die Hauptursache perioperativer Todesfälle. Wesentliche perioperative Komplikationen bei KHK sind Myokardischämien, der Myokardinfarkt, eine akute Linksherzinsuffizienz, Herzrhythmusstörungen sowie der plötzliche postoperative Herztod. Eine medikamentöse Sympathikolyse mittels β-Blockern kann die perioperative kardiale Morbidität und Letalität kardiovaskulärer Hochrisikopatienten senken.

This is a preview of subscription content, log in via an institution.

Literatur

  1. Abraham S, Coles N, Coley C et al (1991) Coronary risk of noncardiac surgery. Prog Cardiovasc Dis 34:205–234

    Article  CAS  PubMed  Google Scholar 

  2. Antman EM, Anbe DT, Armstrong PW et al (2004) ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction – executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 44:671–719

    Article  PubMed  Google Scholar 

  3. Ashley EA, Vagelos RH (2005) Preoperative cardiac evaluation: mechanisms, assessment, and reduction of risk. Thorac Surg Clin 15:263–275

    Article  PubMed  Google Scholar 

  4. Badner NH, Knill RL, Brown JE et al (1998) Myocardial infarction after noncardiac surgery. Anesthesiology 88:572–578

    Article  CAS  PubMed  Google Scholar 

  5. Baumert JH, Falter F, Eletr D et al (2005) Xenon anaesthesia may preserve cardiovascular function in patients with heart failure. Acta Anaesthesiol Scand 49:743–749

    Article  CAS  PubMed  Google Scholar 

  6. Braunwald E, Antman EM, Beasley JW et al (2000) ACC/AHA guidelines for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction: executive summary and recommendations. Circulation 102:1193–1209

    Article  CAS  PubMed  Google Scholar 

  7. Browner WS, Li J, Mangano DT (1992) In-hospital and long-term mortality in male veterans following noncardiac surgery. The Study of Perioperative Ischemia Research Group. JAMA 268:228–232

    Article  CAS  PubMed  Google Scholar 

  8. Brucken A, Coburn M, Rex S et al (2010) Current developments in xenon research. Importance for anesthesia and intensive care medicine. Anaesthesist 59:883–895

    Article  CAS  PubMed  Google Scholar 

  9. Daele, M van, Sutherland G, Mitchell M et al (1990) Do changes in pulmonary capillary wedge pressure adequately reflect myocardial ischemia during anesthesia? Circulation 81:865–871

    Article  CAS  PubMed  Google Scholar 

  10. Dawood MM, Gutpa DK, Southern J et al (1996) Pathology of fatal perioperative myocardial infarction: implications regarding pathophysiology and prevention. Int J Cardiol 57:37–44

    Article  CAS  PubMed  Google Scholar 

  11. Devereaux PJ, Yang H, Yusuf S et al (2008) Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet 371:1839–1847

    Article  CAS  PubMed  Google Scholar 

  12. Devereaux PJ, Sessler DI, Leslie K, Kurz A, Mrkobrada M, Alonso-Coello P et al (2014) Clonidine in patients undergoing noncardiac surgery. N Engl J Med 370:1504–1513

    Article  CAS  PubMed  Google Scholar 

  13. DGAI, DGC, DGIM (2017) Preoperative evaluation of adult patients prior to elective, non-cardiac surgery: joint recommendations of German Society of Anesthesiology and Intensive Care Medicine, German Society of Surgery and German Society of Internal Medicine. Anaesthesist 66(6):442–458

    Google Scholar 

  14. Eagle KA, Berger PB, Calkins H et al (2002) ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery. Circulation 105:1257–1267

    Article  PubMed  Google Scholar 

  15. Eagle KA, Guyton RA, Davidoff R et al (2004) ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 110:e340–e437

    Article  PubMed  Google Scholar 

  16. Faraday N, Martinez EA, Scharpf RB et al (2004) Platelet gene polymorphisms and cardiac risk assessment in vascular surgical patients. Anesthesiology 101:1291–1297

    Article  CAS  PubMed  Google Scholar 

  17. Ferrari R (1996) Prognosis of patients with unstable angina or acute myocardial infarction treated with calcium channel antagonists. Am J Cardiol 77:22D–25D

    Article  CAS  PubMed  Google Scholar 

  18. Fleischmann KE, Beckman JA, Buller CE et al (2009) ACCF/AHA focused update on perioperative beta blockade. J Am Coll Cardiol 54:2102–2128

    Article  PubMed  Google Scholar 

  19. Fleisher LA, Eagle KA (2001) Clinical practice. Lowering cardiac risk in noncardiac surgery. N Engl J Med 345:1677–1682

    Article  CAS  PubMed  Google Scholar 

  20. Fleisher LA, Beckman JA, Brown KA et al (2007) ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery. Circulation 116:1971–1996

    Article  PubMed  Google Scholar 

  21. Fleisher LA, Fleischmann KE, Auerbach AD, Barnason SA, Beckman JA, Bozkurt B, Davila-Roman VG, Gerhard-Herman MD, Holly TA, Kane GC, Marine JE, Nelson MT, Spencer CC, Thompson A, Ting HH, Uretsky BF, Wijeysundera DN (2014) 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 130(24):e278–e333

    Article  Google Scholar 

  22. Fromm RE Jr (2007) Cardiac troponins in the intensive care unit: common causes of increased levels and interpretation. Crit Care Med 35:584–588

    Article  CAS  PubMed  Google Scholar 

  23. Furberg CD, Psaty BM, Meyer JV (1995) Nifedipine. Dose-related increase in mortality in patients with coronary heart disease. Circulation 92:1326–1331

    Article  CAS  PubMed  Google Scholar 

  24. Hamm CW, Heeschen C, Goldmann B et al (1999) Benefit of abciximab in patients with refractory unstable angina in relation to serum troponin T levels. c7E3 Fab Antiplatelet Therapy in Unstable Refractory Angina (CAPTURE) Study Investigators. N Engl J Med 340:1623–1629

    Article  CAS  PubMed  Google Scholar 

  25. Hanss R, Bein B, Turowski P et al (2006) The influence of xenon on regulation of the autonomic nervous system in patients at high risk of perioperative cardiac complications. Br J Anaesth 96:427–436

    Article  CAS  PubMed  Google Scholar 

  26. Hassan SA, Hlatky MA, Boothroyd DB et al (2001) Outcomes of noncardiac surgery after coronary bypass surgery or coronary angioplasty in the Bypass Angioplasty Revascularization Investigation (BARI). Am J Med 110:260–266

    Article  CAS  PubMed  Google Scholar 

  27. Holzer M, Bernard SA, Hachimi-Idrissi S et al (2005) Hypothermia for neuroprotection after cardiac arrest: systematic review and individual patient data meta-analysis. Crit Care Med 33:414–418

    Article  PubMed  Google Scholar 

  28. Howell SJ, Sear JW (2004) Perioperative myocardial injury: individual and population implications. Br J Anaesth 93:3–8

    Article  CAS  PubMed  Google Scholar 

  29. Jambor C, Spannagl M, Zwissler B (2009) Perioperative management of patients with coronary stents in non-cardiac surgery. Anaesthesist 58:971–985

    Article  CAS  PubMed  Google Scholar 

  30. Jürgens E, Spitz R, Zwissler B (2002) Bleibt der KHK Patient 3 Tage auf Intensiv? J Anästh Intensivbehandlung 1(2002):147–150

    Google Scholar 

  31. Juul AB, Wetterslev J, Gluud C et al (2006) Effect of perioperative beta blockade in patients with diabetes undergoing major non-cardiac surgery: randomised placebo controlled, blinded multicentre trial. BMJ 332:1482

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kaluza GL, Joseph J, Lee JR et al (2000) Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol 35:1288–1294

    Article  CAS  PubMed  Google Scholar 

  33. Keller T, Zeller T, Peetz D et al (2009) Sensitive troponin I assay in early diagnosis of acute myocardial infarction. N Engl J Med 361:868–877

    Article  CAS  PubMed  Google Scholar 

  34. Kertai MD (2008) Preoperative coronary revascularization in high-risk patients undergoing vascular surgery: a core review. Anesth Analg 106:751–758

    Article  PubMed  Google Scholar 

  35. Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE, Hert SD, Ford I, Gonzalez-Juanatey JR, Gorenek B, Heyndrickx GR, Hoeft A, Huber K, Iung B, Kjeldsen KP, Longrois D, Lüscher TF, Pierard L, Pocock S, Price S, Roffi M, Sirnes PA, Sousa-Uva M, Voudris V, Funck-Brentano C (2014) 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 35(35):2383–2431

    Article  PubMed  Google Scholar 

  36. Landesburg G, Zhou W, Aversano T (1999) Tachycardia-induced subendocardial necrosis in acutely instrumented dogs with fixed coronary stenosis. Anesth Analg 88:973–979

    Article  CAS  PubMed  Google Scholar 

  37. Lechleitner P (2001) Instabile Angina pectoris: Management des akuten Koronarsyndroms ohne persistierende ST-Hebung. Intensivmed Notfallmed 38:257–263

    Article  Google Scholar 

  38. Lepper W, Kelm M (2007) Perioperative therapy with antiplatelet agents. Anaesthesist 56:592–598

    Article  CAS  PubMed  Google Scholar 

  39. Lindenauer PK, Pekow P, Wang K et al (2005) Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med 353:349–361

    Article  CAS  PubMed  Google Scholar 

  40. Mahla E, Baumann A, Rehak P et al (2007) N-terminal pro-brain natriuretic peptide identifies patients at high risk for adverse cardiac outcome after vascular surgery. Anesthesiology 106:1088–1095

    Article  CAS  PubMed  Google Scholar 

  41. Mangano DT (1990) Perioperative cardiac morbidity. Anesthesiology 72:153–184

    Article  CAS  PubMed  Google Scholar 

  42. Mangano DT, Browner WS, Hollenberg M et al (1990) Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery. N Engl J Med 323:1781–1788

    Article  CAS  PubMed  Google Scholar 

  43. Mangano DT, Browner WS, Hollenberg M et al (1992) Long-term cardiac prognosis following noncardiac surgery. The Study of Perioperative Ischemia Research Group. JAMA 268:233–239

    Article  CAS  PubMed  Google Scholar 

  44. Mangano DT, Layug EL, Wallace A, Tateo I (1996) Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. N Engl J Med 335:1713–1720

    Article  CAS  PubMed  Google Scholar 

  45. Meierhenrich R, Gauss A, Geldner G et al (2000) Importance of acute PTCA in the treatment of perioperative myocardial infarction. Anaesthesist 49:140–148

    Article  CAS  PubMed  Google Scholar 

  46. Metzler H, Huber K, Kozek-Langenecker S et al (2007) Coronary stents, dual antiplatelet therapy and peri-operative problems. Anaesthesist 56:401–412

    Article  CAS  PubMed  Google Scholar 

  47. Monaco M, Stassano P, Di TL et al (2009) Systematic strategy of prophylactic coronary angiography improves long-term outcome after major vascular surgery in medium- to high-risk patients: a prospective, randomized study. J Am Coll Cardiol 54:989–996

    Article  PubMed  Google Scholar 

  48. Monsieurs KG, Nolan JP, Bossaert LL, Greiff R, Maconochie IK, Nikolaou NI, Perkins GD, Soar J, Anatolij Truhlár A, Wyllie J, Zideman DA (2015) European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation 95:1–80

    Article  PubMed  Google Scholar 

  49. Munzer T, Stimming G, Brucker B et al (1996) Perioperative myocardial infarction and cardiac complications after noncardiac surgery in patients with prior myocardial infarction. I. Clinical data and diagnosis, incidence. Anaesthesist 45:213–220

    Article  CAS  PubMed  Google Scholar 

  50. Narins CR, Ling FS, Fischi M et al (2006) In-hospital mortality among women undergoing contemporary elective percutaneous coronary intervention: a reexamination of the gender gap. Clin Cardiol 29:254–258

    Article  PubMed  Google Scholar 

  51. Neill F, Sear JW, French G et al (2000) Increases in serum concentrations of cardiac proteins and the prediction of early postoperative cardiovascular complications in noncardiac surgery patients. Anaesthesia 55:641–647

    Article  CAS  PubMed  Google Scholar 

  52. Nishina K, Mikawa K, Uesugi T et al (2002) Efficacy of clonidine for prevention of perioperative myocardial ischemia: a critical appraisal and meta-analysis of the literature. Anesthesiology 96:323–329

    Article  CAS  PubMed  Google Scholar 

  53. Poldermans D, Boersma E, Bax JJ et al (1999) The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. N Engl J Med 341:1789–1794

    Article  CAS  PubMed  Google Scholar 

  54. Posner KL, Van Norman GA, Chan V (1999) Adverse cardiac outcomes after noncardiac surgery in patients with prior percutaneous transluminal coronary angioplasty. Anesth Analg 89:553–560

    PubMed  CAS  Google Scholar 

  55. Quintin L, Bouilloc X, Butin E et al (1996) Clonidine for major vascular surgery in hypertensive patients: a double-blind, controlled, randomized study. Anesth Analg 83:687–695

    Article  CAS  PubMed  Google Scholar 

  56. Rade JJ, Hogue CW Jr (2008) Noncardiac surgery for patients with coronary artery stents: timing is everything. Anesthesiology 109:573–575

    Article  PubMed  PubMed Central  Google Scholar 

  57. Reichlin T, Hochholzer W, Bassetti S et al (2009) Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med 361:858–867

    Article  CAS  PubMed  Google Scholar 

  58. Savonitto S, D’Urbano M, Caracciolo M et al (2010) Urgent surgery in patients with a recently implanted coronary drug-eluting stent: a phase II study of ‚bridging‘ antiplatelet therapy with tirofiban during temporary withdrawal of clopidogrel. Br J Anaesth 104:285–291

    Article  CAS  PubMed  Google Scholar 

  59. Schouten O, van Domburg RT, Bax JJ et al (2007) Noncardiac surgery after coronary stenting: early surgery and interruption of antiplatelet therapy are associated with an increase in major adverse cardiac events. J Am Coll Cardiol 49:122–124

    Article  PubMed  Google Scholar 

  60. Smith SCJ, Dove JT, Jacobs AK et al (2001) ACC/AHA guidelines of percutaneous coronary interventions (revision of the 1993 PTCA guidelines). J Am Coll Cardiol 37:2215–2238

    Article  PubMed  Google Scholar 

  61. Taittonen MT, Kirvela OA, Aantaa R, Kanto JH (1997) Effect of clonidine and dexmedetomidine premedication on perioperative oxygen consumption and haemodynamic state. Br J Anaesth 78:400–406

    Article  CAS  PubMed  Google Scholar 

  62. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, Katus HA, Lindahl B, Morrow DA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow RO, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasché P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Simoons ML, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S (2012) Third universal definition of myocardial infarction. Circulation 126(16):2020–2035

    Article  PubMed  Google Scholar 

  63. Tillmanns H (2001) Nicht-invasive Akuttherapie des Herzinfarktes. Anaesthesist 50:590–604

    Article  CAS  PubMed  Google Scholar 

  64. Unger EF (2009) Weighing benefits and risks – the FDA‘s review of prasugrel. N Engl J Med 361:942–945

    Article  CAS  PubMed  Google Scholar 

  65. Wallace A, Layug B, Tateo I et al (1998) Prophylactic atenolol reduces postoperative myocardial ischemia. McSPI Research Group. Anesthesiology 88:7–17

    Article  CAS  PubMed  Google Scholar 

  66. Wallace AW, Galindez D, Salahieh A et al (2004) Effect of clonidine on cardiovascular morbidity and mortality after noncardiac surgery. Anesthesiology 101:284–293

    Article  CAS  PubMed  Google Scholar 

  67. Wallace AW, Au S, Cason BA (2011) Perioperative beta-blockade: atenolol is associated with reduced mortality when compared to metoprolol. Anesthesiology 114:824–836

    Article  CAS  PubMed  Google Scholar 

  68. Wang K, Asinger RW, Marriott HJ (2003) ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med 349:2128–2135

    Article  CAS  PubMed  Google Scholar 

  69. Wappler F, Rossaint R, Baumert J et al (2007) Multicenter randomized comparison of xenon and isoflurane on left ventricular function in patients undergoing elective surgery. Anesthesiology 106:463–471

    Article  CAS  PubMed  Google Scholar 

  70. Warltier DC, Pagel PS, Kersten JR (2000) Approaches to the prevention of perioperative myocardial ischemia. Anesthesiology 92:253–259

    Article  CAS  PubMed  Google Scholar 

  71. Wilson SH, Fasseas P, Orford JL et al (2003) Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting. J Am Coll Cardiol 42:234–240

    Article  PubMed  Google Scholar 

  72. Wiviott SD, Braunwald E, McCabe CH et al (2007) Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 357:2001–2015

    Article  CAS  PubMed  Google Scholar 

  73. Yeghiazarians Y, Braunstein JB, Askari A, Stone PH (2000) Unstable angina pectoris. N Engl J Med 342:101–114

    Article  CAS  PubMed  Google Scholar 

  74. Zander J (1997) After the recovery room – which patient where? Intensive care – intensive observation – normal ward. Anaesthesist 46(Suppl 2):S132–S136

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinikum der LMU München, Klinik für Anaesthesiologie, München, Deutschland

    Bernhard Zwißler & Kim Alexander Boost

Authors
  1. Bernhard Zwißler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kim Alexander Boost
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bernhard Zwißler .

Editor information

Editors and Affiliations

  1. Klinik für Anästhesiologie, Universitätsklinikum Aachen RWTH Aachen, Aachen, Germany

    Rolf Rossaint

  2. Universitätsklinikum Mainz Klinik für Anästhesiologie, Mainz, Germany

    Christian Werner

  3. Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum München Klinikum Großhadern, München, Germany

    Bernhard Zwißler

Section Editor information

  1. Klinikum der LMU München, Klinik für Anaesthesiologie, München, Deutschland

    Bernhard Zwißler

Rights and permissions

Reprints and permissions

Copyright information

© 2018 © Springer-Verlag GmbH Deutschland

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Zwißler, B., Boost, K.A. (2018). Anästhesie bei Patienten mit koronarer Herzkrankheit (KHK). In: Rossaint, R., Werner, C., Zwißler, B. (eds) Die Anästhesiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45539-5_89-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-45539-5_89-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45539-5

  • Online ISBN: 978-3-662-45539-5

  • eBook Packages: Springer Referenz Medizin

Publish with us

Policies and ethics

Search

Navigation