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Anästhesie bei Patienten mit koronarer Herzkrankheit (KHK)

  • Bernhard Zwißler
  • Kim Alexander Boost
Living reference work entry
Part of the Springer Reference Medizin book series (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.

Literatur

  1. 1.
    Abraham S, Coles N, Coley C et al (1991) Coronary risk of noncardiac surgery. Prog Cardiovasc Dis 34:205–234CrossRefPubMedGoogle Scholar
  2. 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 44:671–719CrossRefPubMedGoogle Scholar
  3. 3.
    Ashley EA, Vagelos RH (2005) Preoperative cardiac evaluation: mechanisms, assessment, and reduction of risk. Thorac Surg Clin 15:263–275CrossRefPubMedGoogle Scholar
  4. 4.
    Badner NH, Knill RL, Brown JE et al (1998) Myocardial infarction after noncardiac surgery. Anesthesiology 88:572–578CrossRefPubMedGoogle Scholar
  5. 5.
    Baumert JH, Falter F, Eletr D et al (2005) Xenon anaesthesia may preserve cardiovascular function in patients with heart failure. Acta Anaesthesiol Scand 49:743–749CrossRefPubMedGoogle Scholar
  6. 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 102:1193–1209CrossRefPubMedGoogle Scholar
  7. 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 268:228–232CrossRefPubMedGoogle Scholar
  8. 8.
    Brucken A, Coburn M, Rex S et al (2010) Current developments in xenon research. Importance for anesthesia and intensive care medicine. Anaesthesist 59:883–895CrossRefPubMedGoogle Scholar
  9. 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 81:865–871CrossRefPubMedGoogle Scholar
  10. 10.
    Dawood MM, Gutpa DK, Southern J et al (1996) Pathology of fatal perioperative myocardial infarction: implications regarding pathophysiology and prevention. Int J Cardiol 57:37–44CrossRefPubMedGoogle Scholar
  11. 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 371:1839–1847CrossRefPubMedGoogle Scholar
  12. 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 370:1504–1513CrossRefPubMedGoogle Scholar
  13. 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):442–458Google Scholar
  14. 14.
    Eagle KA, Berger PB, Calkins H et al (2002) ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery. Circulation 105:1257–1267CrossRefPubMedGoogle Scholar
  15. 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–e437CrossRefPubMedGoogle Scholar
  16. 16.
    Faraday N, Martinez EA, Scharpf RB et al (2004) Platelet gene polymorphisms and cardiac risk assessment in vascular surgical patients. Anesthesiology 101:1291–1297CrossRefPubMedGoogle Scholar
  17. 17.
    Ferrari R (1996) Prognosis of patients with unstable angina or acute myocardial infarction treated with calcium channel antagonists. Am J Cardiol 77:22D–25DCrossRefPubMedGoogle Scholar
  18. 18.
    Fleischmann KE, Beckman JA, Buller CE et al (2009) ACCF/AHA focused update on perioperative beta blockade. J Am Coll Cardiol 54:2102–2128CrossRefPubMedGoogle Scholar
  19. 19.
    Fleisher LA, Eagle KA (2001) Clinical practice. Lowering cardiac risk in noncardiac surgery. N Engl J Med 345:1677–1682CrossRefPubMedGoogle Scholar
  20. 20.
    Fleisher LA, Beckman JA, Brown KA et al (2007) ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery. Circulation 116:1971–1996CrossRefPubMedGoogle Scholar
  21. 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–e333CrossRefGoogle Scholar
  22. 22.
    Fromm RE Jr (2007) Cardiac troponins in the intensive care unit: common causes of increased levels and interpretation. Crit Care Med 35:584–588CrossRefPubMedGoogle Scholar
  23. 23.
    Furberg CD, Psaty BM, Meyer JV (1995) Nifedipine. Dose-related increase in mortality in patients with coronary heart disease. Circulation 92:1326–1331CrossRefPubMedGoogle Scholar
  24. 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 340:1623–1629CrossRefPubMedGoogle Scholar
  25. 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 96:427–436CrossRefPubMedGoogle Scholar
  26. 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 110:260–266CrossRefPubMedGoogle Scholar
  27. 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 33:414–418CrossRefPubMedGoogle Scholar
  28. 28.
    Howell SJ, Sear JW (2004) Perioperative myocardial injury: individual and population implications. Br J Anaesth 93:3–8CrossRefPubMedGoogle Scholar
  29. 29.
    Jambor C, Spannagl M, Zwissler B (2009) Perioperative management of patients with coronary stents in non-cardiac surgery. Anaesthesist 58:971–985CrossRefPubMedGoogle Scholar
  30. 30.
    Jürgens E, Spitz R, Zwissler B (2002) Bleibt der KHK Patient 3 Tage auf Intensiv? J Anästh Intensivbehandlung 1(2002):147–150Google Scholar
  31. 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 332:1482CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Kaluza GL, Joseph J, Lee JR et al (2000) Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol 35:1288–1294CrossRefPubMedGoogle Scholar
  33. 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 361:868–877CrossRefPubMedGoogle Scholar
  34. 34.
    Kertai MD (2008) Preoperative coronary revascularization in high-risk patients undergoing vascular surgery: a core review. Anesth Analg 106:751–758CrossRefPubMedGoogle Scholar
  35. 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):2383–2431CrossRefPubMedGoogle Scholar
  36. 36.
    Landesburg G, Zhou W, Aversano T (1999) Tachycardia-induced subendocardial necrosis in acutely instrumented dogs with fixed coronary stenosis. Anesth Analg 88:973–979CrossRefPubMedGoogle Scholar
  37. 37.
    Lechleitner P (2001) Instabile Angina pectoris: Management des akuten Koronarsyndroms ohne persistierende ST-Hebung. Intensivmed Notfallmed 38:257–263CrossRefGoogle Scholar
  38. 38.
    Lepper W, Kelm M (2007) Perioperative therapy with antiplatelet agents. Anaesthesist 56:592–598CrossRefPubMedGoogle Scholar
  39. 39.
    Lindenauer PK, Pekow P, Wang K et al (2005) Perioperative beta-blocker therapy and mortality after major noncardiac surgery. N Engl J Med 353:349–361CrossRefPubMedGoogle Scholar
  40. 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 106:1088–1095CrossRefPubMedGoogle Scholar
  41. 41.
    Mangano DT (1990) Perioperative cardiac morbidity. Anesthesiology 72:153–184CrossRefPubMedGoogle Scholar
  42. 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 323:1781–1788CrossRefPubMedGoogle Scholar
  43. 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 268:233–239CrossRefPubMedGoogle Scholar
  44. 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 335:1713–1720CrossRefPubMedGoogle Scholar
  45. 45.
    Meierhenrich R, Gauss A, Geldner G et al (2000) Importance of acute PTCA in the treatment of perioperative myocardial infarction. Anaesthesist 49:140–148CrossRefPubMedGoogle Scholar
  46. 46.
    Metzler H, Huber K, Kozek-Langenecker S et al (2007) Coronary stents, dual antiplatelet therapy and peri-operative problems. Anaesthesist 56:401–412CrossRefPubMedGoogle Scholar
  47. 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 54:989–996CrossRefPubMedGoogle Scholar
  48. 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 95:1–80CrossRefPubMedGoogle Scholar
  49. 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 45:213–220CrossRefPubMedGoogle Scholar
  50. 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 29:254–258CrossRefPubMedGoogle Scholar
  51. 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 55:641–647CrossRefPubMedGoogle Scholar
  52. 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 96:323–329CrossRefPubMedGoogle Scholar
  53. 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 341:1789–1794CrossRefPubMedGoogle Scholar
  54. 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 89:553–560PubMedGoogle Scholar
  55. 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 83:687–695CrossRefPubMedGoogle Scholar
  56. 56.
    Rade JJ, Hogue CW Jr (2008) Noncardiac surgery for patients with coronary artery stents: timing is everything. Anesthesiology 109:573–575CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Reichlin T, Hochholzer W, Bassetti S et al (2009) Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med 361:858–867CrossRefPubMedGoogle Scholar
  58. 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 104:285–291CrossRefPubMedGoogle Scholar
  59. 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 49:122–124CrossRefPubMedGoogle Scholar
  60. 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 37:2215–2238CrossRefPubMedGoogle Scholar
  61. 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 78:400–406CrossRefPubMedGoogle Scholar
  62. 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):2020–2035CrossRefPubMedGoogle Scholar
  63. 63.
    Tillmanns H (2001) Nicht-invasive Akuttherapie des Herzinfarktes. Anaesthesist 50:590–604CrossRefPubMedGoogle Scholar
  64. 64.
    Unger EF (2009) Weighing benefits and risks – the FDA‘s review of prasugrel. N Engl J Med 361:942–945CrossRefPubMedGoogle Scholar
  65. 65.
    Wallace A, Layug B, Tateo I et al (1998) Prophylactic atenolol reduces postoperative myocardial ischemia. McSPI Research Group. Anesthesiology 88:7–17CrossRefPubMedGoogle Scholar
  66. 66.
    Wallace AW, Galindez D, Salahieh A et al (2004) Effect of clonidine on cardiovascular morbidity and mortality after noncardiac surgery. Anesthesiology 101:284–293CrossRefPubMedGoogle Scholar
  67. 67.
    Wallace AW, Au S, Cason BA (2011) Perioperative beta-blockade: atenolol is associated with reduced mortality when compared to metoprolol. Anesthesiology 114:824–836CrossRefPubMedGoogle Scholar
  68. 68.
    Wang K, Asinger RW, Marriott HJ (2003) ST-segment elevation in conditions other than acute myocardial infarction. N Engl J Med 349:2128–2135CrossRefPubMedGoogle Scholar
  69. 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 106:463–471CrossRefPubMedGoogle Scholar
  70. 70.
    Warltier DC, Pagel PS, Kersten JR (2000) Approaches to the prevention of perioperative myocardial ischemia. Anesthesiology 92:253–259CrossRefPubMedGoogle Scholar
  71. 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 42:234–240CrossRefPubMedGoogle Scholar
  72. 72.
    Wiviott SD, Braunwald E, McCabe CH et al (2007) Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 357:2001–2015CrossRefPubMedGoogle Scholar
  73. 73.
    Yeghiazarians Y, Braunstein JB, Askari A, Stone PH (2000) Unstable angina pectoris. N Engl J Med 342:101–114CrossRefPubMedGoogle Scholar
  74. 74.
    Zander J (1997) After the recovery room – which patient where? Intensive care – intensive observation – normal ward. Anaesthesist 46(Suppl 2):S132–S136CrossRefPubMedGoogle Scholar

Copyright information

© © Springer-Verlag GmbH Deutschland 2018

Authors and Affiliations

  1. 1.Klinikum der LMU München, Klinik für AnaesthesiologieMünchenDeutschland

Section editors and affiliations

  • Bernhard Zwißler
    • 1
  1. 1.Klinikum der LMU München, Klinik für AnaesthesiologieMünchenDeutschland

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