Möllmann H, Szardien S, Kempfert J, Nef H, Liebetrau C, Walther T, Hamm C
Abteilung für Kardiologie, Kerckhoff-Klinik Bad Nauheim, Benekestrasse 2-8, Bad Nauheim, Germany.
Herz. 2013 Aug;38(5):513-26; quiz 527-8. doi: 10.1007/s00059-013-3917-9.
Coronary artery disease (CAD) is a leading cause of morbidity and mortality in western countries and is of significant socio-economic importance due to its increasing prevalence. Until percutaneous coronary interventions (PCI) were established, CAD could only be treated by surgical revascularization or pharmacological therapy. In-stent restenosis remains a major problem after stent implantation. However, the use of new materials and stent coatings have led to a significant reduction in in-stent restenosis. Thus, surgical revascularization and PCI are currently of equal value for the treatment of CAD. The decision-making for PCI or surgical revascularization depends on various factors such as number of diseased vessels, complexity of the coronary stenoses, concomitant diseases, and the patient's general condition. The therapeutic regime of every patient should be adjusted to the recommendations of the European and German Society for Cardiology, while controversial and complex cases should be discussed in an interdisciplinary case conference ("heart team").
冠状动脉疾病（CAD）是西方国家发病和死亡的主要原因，由于其患病率不断上升，具有重大的社会经济意义。在经皮冠状动脉介入治疗（PCI）确立之前，CAD只能通过外科血管重建术或药物治疗。支架内再狭窄仍然是支架植入后的一个主要问题。然而，新材料和支架涂层的使用已导致支架内再狭窄显著减少。因此，目前外科血管重建术和PCI在CAD治疗中具有同等价值。PCI或外科血管重建术的决策取决于多种因素，如病变血管数量、冠状动脉狭窄的复杂性、伴随疾病以及患者的一般状况。每位患者的治疗方案应根据欧洲和德国心脏病学会的建议进行调整，而有争议和复杂的病例应在跨学科病例讨论会上（“心脏团队”）进行讨论。
