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Der Klinikarzt 2020; 49(07/08): 326-334
DOI: 10.1055/a-1208-3350
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Praxisempfehlungen: Labordiagnostik bei akutem Koronarsyndrom

Klinische Anwendung von Troponin-basierten Diagnosealgorithmen bei vermutetem Myokardinfarkt
Paul M. Haller
1   Abteilung für Kardiologie, Universitäres Herz und Gefäßzentrum UKE Hamburg
,
Stefan Blankenberg
1   Abteilung für Kardiologie, Universitäres Herz und Gefäßzentrum UKE Hamburg
› Author Affiliations
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Publication History

Publication Date:
28 August 2020 (online)

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ZUSAMMENFASSUNG

Die rasche Triagierung von Patienten mit Verdacht eines akuten Koronarsyndroms ist essenziell. Der zeitnahe Ausschluss eines akuten Myokardinfarktes kann Wartezeiten und Kapazitäten in den Notaufnahmen reduzierten. Eine rasche und präzise Identifikation von Patienten mit akutem Myokardinfarkt ist zur zeitgerechten Einleitung einer Therapie obligat. Vor allem nach Ausschluss eines akuten ST-Hebungsinfarktes mittels Elektrokardiogramm wird das weitere Vorgehen maßgeblich durch die Labordiagnostik bestimmt. Die Erfassung des myokardspezifischen Proteins Troponin mittels hoch-sensitiven Assays stellt als direkter Nachweis eines Myokardschadens den Goldstandard dar. Mithilfe Troponin-basierter Diagnosealgorithmen werden Patienten in Abhängigkeit ihres Risikos an einem akuten Myokardinfarkt zu leiden stratifiziert. Die vorliegende Übersichtsarbeit fasst die aktuell verfügbare Literatur zur Labordiagnostik beim akuten Koronarsyndrom zusammen. Schwerpunkt hierbei ist die klinische Anwendung von (hoch-sensitiven) Troponin-Assays, der Einfluss von Begleiterkrankungen auf die Diagnostik sowie mögliche individuelle Anwendungskonzepte in der Diagnostik und Risikoprädiktion.

 

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