Hamostaseologie 2006; 26(03): 201-207
DOI: 10.1055/s-0037-1617063
Original Article
Schattauer GmbH

Prädiktive Marker der Krankheitsprogression bei pAVK

Welche sind praxisrelevant und ökonomisch vertretbar?Markers predicting progression of disease in PADWhich of them are both relevant to clinical practice and economically justifiable?
B.-M. Taute
1   Schwerpunkt Angiologie (Leitung: Prof. Dr. med. H. Podhaisky) der Universitätsklinik und Poliklinik für Innere Medizin III (Direktor: Prof. Dr. med. K. Werdan) an der Martin-Luther-Universität Halle- Wittenberg
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2017 (online)

Zusammenfassung

Die hohe kardiovaskuläre Morbidität und Mortalität ist bei peripherer arterieller Verschlusskrankheit (pAVK) auf die ausgeprägte Generalisationstendenz des atherosklerotischen Prozesses, die systemische Atheroskleroseprogression, zurückzuführen. Das entscheidende Ziel im Management einer pAVK besteht in der Prävention der systemischen Progression. Eine Verbesserung der Prognose wird durch Früherkennung und frühzeitige individuelle Risikoprädiktion mit nachfolgender risikoadaptierter Prävention und einer kausal orientierten Therapie möglich. Früherkennung und Risikoprädiktion sind Maßnahmen, die bereits in der hausärztlichen Praxis angesiedelt sind. Für die individuelle Risikostratifizierung bedarf es deshalb praktikabler und ökonomisch vertretbarer Parameter, die dennoch hohen prädiktiven Wert besitzen. Geeignet sind die vaskulären Indikatoren Knöchel-Arm-Druckindex (ABI) und Lokalisationstyp der pAVK sowie die klassischen vaskulären Risikofaktoren unter Einschluss des Homozysteins. Die gewichtete Zusammenführung dieser Parameter in einen multivariablen Risiko-Score ermöglicht die Identifikation des Höchstrisikokollektivs für eine frühzeitige Generalisation der Atherosklerose bei pAVK.

Summary

The high cardiovascular morbidity and mortality on peripheral arterial disease (PAD) are attributable to the pronounced tendency to generalization of the atherosclerotic process, the systemic progression of atherosclerosis. The crucial objective in management of a PAD consists in preventing systemic progression. The prognosis can be improved by early diagnosis and early prediction of individual risk with subsequent risk-adapted prevention and causal therapy. Early diagnosis and risk prediction are measures that are already part of the repertory of the general practitioner. Practicable and economically justifiable parameters that nevertheless have a high predictive value are therefore required to stratify individual risk. The vascular indicators ankle-arm index and the localization of the PAD as well as the classical cardiovascular risk factors including homocysteine are suitable. Weighting of these parameters in a multivariable risk score enable the population with the highest risk of early generalization of atherosclerosis to be identified in PAD.

 
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