Zusammenfassung
Der akute Myokardinfarkt mit ST-Hebungen stellt eine der Haupttodesursachen in den
westlichen Industriestaaten dar. Das primäre Therapieziel liegt in der raschen Wiedereröffnung
des verschlossenen Herzkranzgefäßes. Dies kann entweder durch eine prähospitale Lyse
oder eine Akut-PTCA (perkutane transluminale Koronarangioplastie) erreicht werden.
Bisherige Studien, die eine prähospitale Lyse mit einer Akut-PTCA verglichen haben,
zeigen teilweise uneinheitliche Ergebnisse. Im Rahmen dieser Übersichtsarbeit soll
die aktuelle Studienlage beleuchtet werden und auf die geltenden Leitlinien zur Behandlung
des akuten Infarktes mit ST-Streckenhebungen eingegangen werden. Zudem werden Wirkmechanismus,
Voraussetzungen sowie Kontraindikationen für eine prähospitale Lyse erläutert.
Abstract
Acute ST-elevation myocardial infarctions are one of the major causes for morbidity
and mortality in the industrial world. Rapid reopening of the occluded coronary vessel
is the major goal in this setting. Prehospital lysis and acute PCI (percutaneous coronary
intervention) are two alternatives to obtain this goal. Studies comparing prehospital
lysis with acute PCI have shown inconsistent results. This review tries to elucidate
current studies and guidelines for the treatment of acute ST-elevation myocardial
infarctions. Additionally, mechanisms, indications and contraindications for prehospital
lysis are discussed.
Schlüsselwörter
Prähospitale Lyse - ST-Hebungsinfarkt - Akut-PTCA
Key words
Prehospital lysis - ST-elevation myocardial infarction - acute PCI
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Priv.-Doz. Dr. med. Stephen Schröder
Medizinische Universitätsklinik · Innere Medizin III
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