Zusammenfassung
Die nach der akuten Therapie des Myokardinfarkts beginnende chronische Therapie ist von großer Bedeutung für die Lebensqualität und Prognose der erkrankten Patienten. Frühere Untersuchungen zeigten, daß in den westlichen, industrialisierten Ländern selbst lange etablierte Therapieprinzipien noch nicht bei allen Patienten eingesetzt werden.
In dieser Übersichtsarbeit sind die heute bewiesenen Therapiestrategien zusammen mit den größten relevanten klinischen Studien dargestellt. Die wichtigsten Bausteine der langfristigen Infarkttherapie sind die adrenergen Betarezeptorenblocker, die ACE-Hemmer, die Thrombozytenaggregationshemmer sowie die Lipidsenker. Das Ausmaß der Verbesserung der Überlebenszeit mit diesen Substanzen wird anhand der Diskussion der zugrundeliegenden Studien dargestellt. Weitere medikamentöse, noch nicht bewiesene Ansätze, wie die Angiotensinrezeptorblocker (AT1-Antagonisten) und antioxidative Substanzen, werden diskutiert.
Abstract
This review article summarizes the long-term standard therapy for patients with myocardial infarction. The chronic therapy is able to significantly improve quality of life and survival of affected patients. Previous studies showed that in most western countries, the established standard therapy is not given to all patients who would benefit from chronic treatment.
The essential parts of today’s myocardial infarction treatment consists of effective beta-blockade, inhibition of the angiotensin-conversion enzyme, inhibition of platelet aggregation and lipid lowering agents. This article reviews the clinical benefits which may be expected from each of these therapeutic approaches. Newer, but not yet proven strategies, like blockade of the angiotensin receptor subtype 1 and treatment with antioxidative agents will be discussed.
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Willenbrock, R., Monti, J. & Dietz, R. Medikamentöse Therapie zur Prognoseverbesserung nach akutem Myokardinfarkt. Herz 24, 389–397 (1999). https://doi.org/10.1007/BF03043930
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DOI: https://doi.org/10.1007/BF03043930