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Erschienen in: Notfall +  Rettungsmedizin 1/2018

21.12.2017 | Leitthema

Empfehlungen der Europäischen Gesellschaft für Kardiologie-Leitlinien 2017 – STEMI

verfasst von: Univ.-Prof. Dr. med. H. Thiele

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 1/2018

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Zusammenfassung

In diesem Beitrag werden die aktuellen Leitlinien der Europäischen Gesellschaft für Kardiologie aus dem Jahr 2017 zur Diagnostik und Therapie des akuten ST-Strecken-Hebungsinfarkts (STEMI) dargelegt und v. a. die Änderungen im Vergleich zu den früheren STEMI-Leitlinien von 2012 herausgearbeitet. Die primäre perkutane Koronarintervention (PCI) bleibt die bevorzugte Reperfusionstherapie. Veränderungen hinsichtlich der Revaskularisation betreffen besonders Empfehlungen zur Wahl des radialen Zugangswegs, zur Verwendung von Drug-Eluting-Stents anstelle von Bare-Metal-Stents sowie zur kompletten Revaskularisation und Vermeidung der Thrombusaspiration. Bei der Begleittherapie während der PCI wurde Bivalirudin herabgestuft. Die Indikation für eine O2-Therapie ist nur noch bei einer O2-Sättigung von <90 % gegeben. Die intraaortale Ballonpumpe sollte im kardiogenen Schock nicht mehr verwendet werden. Neue Empfehlungen gibt es auch in Bezug auf die Dauer der dualen Antiplättchentherapie für Patienten, bei denen nach den initialen 12 Monaten kein Blutungsereignis aufgetreten ist. Neue überarbeitete Abschnitte betreffen den Myokardinfarkt ohne relevante Koronarstenosen, die Einführung von Qualitätsindikatoren für Herzinfarktnetzwerke und neue Definitionen für die Zeiten bis zur Reperfusion.
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Metadaten
Titel
Empfehlungen der Europäischen Gesellschaft für Kardiologie-Leitlinien 2017 – STEMI
verfasst von
Univ.-Prof. Dr. med. H. Thiele
Publikationsdatum
21.12.2017
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 1/2018
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-017-0402-7

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