Die Rolle der Thrombozyten in der Pathophysiologie des akuten Koronarsyndroms

Zusammenfassung

Kardiovaskuläre Erkrankungen, besonders die koronare Herzkrankheit, stellen derzeit die häufigste Todesursache in der westlichen Welt dar und repräsentieren eine zentrale Herausforderung für moderne Wissenschaft und Medizin. Die Pathophysiologie der koronaren Herzkrankheit basiert im Wesentlichen auf der Entstehung und dem biologischen Remodelling atherosklerotischer Plaques. Vor allem in fortgeschrittenen Stadien, aber auch in der frühen Phase der Atherosklerose, kommt es zur Ruptur atherosklerotischer Plaques, die zur klinischen Manifestation des akuten Koronarsyndroms in Form instabiler Angina pectoris, nicht transmuralen oder transmuralen Myokardinfarkts führen kann. Neben inflammatorischen Zellen wie Monozyten, spielen Thrombozyten eine essenzielle Rolle in der frühen wie auch der späten Phase atherosklerotischer Erkrankungen.

Diese Übersicht fasst die grundlegenden pathophysiologischen Mechanismen der Plättchenadhäsion und -sekretion, die molekularen Schritte, die in die plättchenvermittelte Thrombusentstehung im Bereich atherosklerotischer Läsionen eingreifen und die Bedeutung der Thrombozytenakkumulation im reperfundierten Myokard zusammen.

Summary

Cardiovascular diseases, especially ischaemic heart disease, are actually the most frequent causes of death in the Western world and represent a central challenge for modern research and medicine. The pathophysiology of ischaemic heart disease is based upon the development and biological remodelling of atherosclerotic plaques. Mainly at late stages, but also in the early phase of atherosclerosis, rupture of the atherosclerotic plaque occurs and may lead to the clinical manifestation of acute coronary syndromes, including unstable angina pectoris, non-transmural or transmural myocardial infarction. Next to inflammation mediating cells like monocytes, platelets play an essential role at early and late stages of atherosclerotic disorders.

This review summarizes the basic pathophysiological mechanism of platelet adhesion and secretion, the molecular steps involved in platelet mediated thrombus formation in the atherosclerotic microenvironment and the role of platelet accumulation in reperfused myocardium. The role of platelets for the pathophysiology of acute coronary syndromes

Schlüsselwörter

Akutes Koronarsyndrom - Atherosklerose - Thrombozyten - Myokardinfarkt

Keywords

Acute coronary syndrom - atherosclerosis - platelets - myocardial infarction

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