Nixdorff U, Horstick G, Schlitt A
European Prevention Center im Medical Center Düsseldorf (GrandArc), Luise-Rainer-Str. 6-10, 40235, Düsseldorf, Deutschland.
Praxis für Gefäß- und Herzmedizin, Neustadt a. d. Weinstraße, Deutschland.
Herz. 2019 Feb;44(1):45-52. doi: 10.1007/s00059-019-4782-y.
For life style modifications primary and secondary prevention of acute coronary syndrome (ACS) are approximately similar, even though in the postinfarction situation functional diagnostic programs have to be performed in a rehabilitative manner. All three life style pillars of fitness, nutrition and relaxation implicate prognostic significance and the efficacy is higher for secondary prevention than for primary. The pharmacotherapeutic indications for thrombocyte aggregation inhibition are connected to the presence of atherosclerosis and statin medication is already connected to cardiovascular risk factor stratification, for which scores are used. Depending on the postinfarction myocardial destruction after ACS, additional pharmacotherapies, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin-II receptor antagonists, beta blockers and also mineral corticoid receptor antagonists are evident. New potential for prevention is ascribed to the new oral anticoagulants (NOAC) in the context of coincidental atrial fibrillation.
对于急性冠状动脉综合征(ACS)的一级和二级预防,生活方式的改变大致相似,尽管在心肌梗死后的情况下,功能诊断程序必须以康复的方式进行。健身、营养和放松这三个生活方式支柱都具有预后意义,二级预防的效果高于一级预防。血小板聚集抑制的药物治疗指征与动脉粥样硬化的存在有关,他汀类药物治疗已与心血管危险因素分层相关,为此使用了评分系统。根据ACS后梗死心肌的破坏情况,其他药物治疗,如血管紧张素转换酶(ACE)抑制剂、血管紧张素II受体拮抗剂、β受体阻滞剂以及盐皮质激素受体拮抗剂是明显的。在合并心房颤动的情况下,新型口服抗凝剂(NOAC)被认为具有新的预防潜力。