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Hamostaseologie 1992; 12(02): 073-081
DOI: 10.1055/s-0038-1660319
DOI: 10.1055/s-0038-1660319
Übersichtsarbeit/Review Articles
Intravenöse Thrombolysetherapie des akuten Herzinfarktes
Aktueller Stand 1992Further Information
Publication History
Publication Date:
26 June 2018 (online)
Zusammenfassung
Die intravenöse Thrombolysetherapie kann, insbesondere bei frühzeitigem Einsatz, die Sterblichkeit beim akuten Herzinfarkt wesentlich vermindern. Derzeit stehen vier unterschiedliche Thrombolytika (Streptokinase, APSAC, Urokinase und rt-PA) kommerziell zur Verfügung. Im klinischen Gebrauch unterscheiden sie sich insbesondere in der Geschwindigkeit, mit der sie die Thrombolyse herbeiführen, und in ihrer Fibrinspezifität. Inwieweit diese unterschiedlichen Eigenschaften die Prognose der Patienten wesentlich beeinflussen, wird derzeit noch kontrovers diskutiert.
Sofern Urokinase oder rt-PA zum Einsatz kommen, ist eine begleitende Heparintherapie unerläßlich. Um späteren Reinfarkten vorzubeugen, sollte - in Abhängigkeit vom klinischen Verlauf des Patienten - vor der Entlassung aus dem Krankenhaus oder im stabilen Intervall eine invasive Diagnostik mittels Herzkatheter und bei Vorhandensein höhergradiger Stenosen eine Dilatationsbehandlung oder Bypass-Operation durchgeführt werden.
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