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Empfehlungen zur Organisation von Herzinfarktnetzwerken

Recommendations for the organization of acute myocardial infarction networks

  • Empfehlungen
  • Published:
Der Kardiologe Aims and scope

Zusammenfassung

Jährlich erleiden in Deutschland ca. 205.000 Menschen einen akuten Myokardinfarkt. Kernelement der optimalen Behandlung des ST-Hebungsmyokardinfarktes (STEMI) stellt die rasche und vollständige Reperfusion der verschlossenen Koronararterie dar. Zum Erreichen dieses Zieles ist die unverzügliche primäre perkutane Koronarintervention (pPCI) einer Thrombolysetherapie überlegen. Zur Verbesserung der Versorgung von STEMI-Patienten fordern die ESC-Leitlinien nachdrücklich zur Schaffung regionaler Herzinfarktnetzwerke auf, um die Zeit zwischen Symptombeginn und effektiver Reperfusion der verschlossenen Koronararterie kürzestmöglich zu halten. Die genaue Strukturierung von Herzinfarktnetzwerken bedarf vielfältiger formaler, logistischer und inhaltlicher Überlegungen. Derartige „Ausführungshinweise“ sind nicht Teil der Leitlinien und liegen in standardisierter Form bislang nicht vor. Das Positionspapier möchte, basierend auf der verfügbaren Datenlage und den Leitlinien, Empfehlungen zur Implementierung eines optimalen Herzinfarktnetzwerkes geben.

Abstract

In Germany approximately 205,000 patients experience an acute myocardial infarction annually. The main treatment strategy for ST segment elevation myocardial infarction (STEMI) is timely reperfusion of the coronary artery affected, primarily by percutaneous coronary intervention (pPCI), which is in general superior to systemic thrombolysis. In order to achieve these goals the European Society of Cardiology (ESC) guidelines encourage the establishment of regional networks for optimization of treatment and treatment times in STEMI patients. However, detailed information about how to establish and organize myocardial infarction networks are not provided by current guidelines. Therefore, this paper aims to address these gaps and proposes a structure for implementing and maintaining an optimized network according to currently available data.

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Abb. 1

Abbreviations

ACC:

American College of Cardiology

ACS:

Akutes Koronarsyndrom

ÄLRD:

Ärztlicher Leiter Rettungsdienst

AHA:

American Heart Association

CBT:

Arzterstkontakt-Ballon-Zeit („contact to balloon time“)

DBT:

Krankenhausankunft-Ballon-Zeit („door to ballon time“)

DGK:

Deutsche Gesellschaft für Kardiologie

DRG:

Diagnosis related Groups

ESC:

European Society of Cardiology

FMC:

First Medical Contact

FITT-STEMI:

Feedback intervention and treatment times in STEMI

IMC:

Intermediate Care

NSTEMI:

Nicht-ST-Hebungsmyokardinfarkt

PCI:

Perkutane Koronarintervention

pPCI:

Primäre perkutane Katheterintervention

PRD:

Procedure related delay

STEMI:

ST-Hebungsmyokardinfarkt

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Einhaltung ethischer Richtlinien

Interessenkonflikt. S.K.G. Maier, H. Thiele, R. Zahn, P. Sefrin, C.K. Naber, K.H. Scholz und W. von Scheidt geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. II. Medizinische Klinik, Klinikum St. Elisabeth Straubing, St. Elisabethstr. 23, 94315, Straubing, Deutschland

    S.K.G. Maier

  2. Deutsches Zentrum für Herzinsuffizienz Würzburg, Würzburg, Deutschland

    S.K.G. Maier

  3. Herzzentrum, Klinik für Innere Medizin/Kardiologie, Universität Leipzig, Leipzig, Deutschland

    H. Thiele

  4. Kardiologie, Herzzentrum Ludwigshafen, Ludwigshafen, Deutschland

    R. Zahn

  5. Bundesvereinigung der Arbeitsgemeinschaften der Notärzte Deutschlands, Würzburg, Deutschland

    P. Sefrin

  6. Contilia Herz und Gefäßzentrum, Klinik für Kardiologie und Angiologie, Elisabeth‐Krankenhaus Essen, Essen, Deutschland

    C.K. Naber

  7. Klinik für Kardiologie und Intensivmedizin, St Bernwald Krankenhaus, Hildesheim, Deutschland

    K.H. Scholz

  8. I. Medizinische Klinik, Klinikum Augsburg, Herzzentrum Augsburg-Schwaben, Augsburg, Deutschland

    W. von Scheidt

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  1. S.K.G. Maier
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  2. H. Thiele
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  3. R. Zahn
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  6. K.H. Scholz
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  7. W. von Scheidt
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Correspondence to S.K.G. Maier.

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Maier, S., Thiele, H., Zahn, R. et al. Empfehlungen zur Organisation von Herzinfarktnetzwerken. Kardiologe 8, 36–44 (2014). https://doi.org/10.1007/s12181-013-0540-1

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