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Antithrombotische Therapie nach strukturellen kardialen Interventionen

Empfehlung der Arbeitsgruppe Kardiovaskuläre Hämostase und Antithrombotische Therapie (AG19) der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. (DGK) in Zusammenarbeit mit der Arbeitsgruppe Interventionelle Kardiologie (AG6) – AGIK und der Arbeitsgruppe Klinische Pharmakologie (AG22) der DGK

Antithrombotic therapy after structural cardiac interventions

Recommendations of the Working Group on Cardiovascular Hemostasis and Antithrombotic Therapy (AG19) of the German Cardiac Society (DGK) in cooperation with the Working Group on Interventional Cardiology (AG6, AGIK) and the Working Group on Clinical Pharmacology (AG22) of the DGK

  • Empfehlungen und Stellungnahmen
  • Published:
Der Kardiologe Aims and scope

Zusammenfassung

In den letzten Jahren finden strukturelle kardiale Interventionen zunehmend Anwendung in der klinischen Routine. Trotz der raschen Einführung und Weiterentwicklung dieser Techniken, ist die Evidenz für die optimale antithrombotische Therapie nach solchen Interventionen limitiert, da randomisierte Studien zum Vergleich verschiedener antithrombotischer Therapien für die meisten Einsatzgebiete fehlen. Diese Empfehlung fasst den gegenwärtigen Erkenntnisstand zusammen. Basierend auf den zur Verfügung stehenden Daten, werden Behandlungsempfehlungen formuliert, die Ärzten und ihren Patienten die Entscheidungsfindung erleichtern sollen.

Abstract

In recent years, structural cardiac interventions became an important part of cardiovascular medicine. Despite the rapid development and evolution of these interventional techniques, there is a significant lack of evidence regarding the optimal antithrombotic treatment strategy as randomized trials on this issue are missing for most of these interventions. Thus, this manuscript summarizes the current level of evidence. The listed recommendations are based on available data as well as expert opinion and aim to guide physicians in making decisions for the treatment of patients in this setting.

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Abbreviations

ACT:

Activated clotting time

ASD:

Atrialer Septumdefekt

ASS:

Acetylsalicylsäure

DAPT:

Duale antithrombozytäre Therapie

DGK:

Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V.

DRT:

Device-related thrombosis/Device-assoziierte Thrombose

LAAC:

Left atrial appendage closure/linker Vorhofohrverschluss

NOAK:

Nicht-Vitamin-K-antagonistisches orales Antikoagulans

OAK:

Orale Antikoagulation

PFO:

Persistierendes Foramen ovale

TAVI:

Transcatheter aortic valve implantation/Transkatheter-Aortenklappenimplantation

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Author information

Authors and Affiliations

  1. Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg ∙ Bad Krozingen, Südring 15, 79189, Bad Krozingen, Deutschland

    Willibald Hochholzer, Thomas Nührenberg & Franz-Josef Neumann

  2. Klinik für Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover, Deutschland

    Ulrike Flierl & Andreas Schäfer

  3. Klinik für Kardiologie und Angiologie I, Universitäts-Herzzentrum Freiburg ∙ Bad Krozingen, Freiburg, Deutschland

    Christoph B. Olivier & Daniel Dürschmied

  4. Klinik für Kardiologie, CharitéCentrum für Herz‑, Kreislauf- und Gefäßmedizin, Charité Universitätsmedizin Berlin, Berlin, Deutschland

    Ulf Landmesser

  5. Klinik für Innere Medizin I, St.-Johannes-Hospital Dortmund, Dortmund, Deutschland

    Helge Möllmann

  6. Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Deutschland

    Marcus Dörr

  7. Medizinische Klinik und Poliklinik I, Klinikum der Universität München, München, Deutschland

    Julinda Mehilli & Dirk Sibbing

  8. Institut für Klinische Pharmakologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Deutschland

    Ali El-Armouche

  9. Klinik für Kardiologie, Pneumologie, Angiologie und Internistische Intensivmedizin, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Deutschland

    Uwe Zeymer

  10. Klinik für Kardiologie und internistische Intensivmedizin, Krankenhaus der Augustinerinnen, Köln, Deutschland

    Ingo Ahrens

  11. Innere Medizin III – Kardiologie und Angiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland

    Tobias Geisler

  12. Kommission für Klinische Kardiovaskuläre Medizin, Deutsche Gesellschaft für Kardiologie, Düsseldorf, Deutschland

    Ulf Landmesser

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  1. Willibald Hochholzer
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Correspondence to Willibald Hochholzer.

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Hochholzer, W., Nührenberg, T., Flierl, U. et al. Antithrombotische Therapie nach strukturellen kardialen Interventionen. Kardiologe 15, 57–70 (2021). https://doi.org/10.1007/s12181-020-00441-w

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