Buske Maria, Feistritzer Hans-Josef, Jobs Alexander, Thiele Holger
Herzzentrum Leipzig, Universitätsklinik für Kardiologie, Strümpellstr. 39, 04289, Leipzig, Deutschland.
Herz. 2025 Feb;50(1):66-76. doi: 10.1007/s00059-024-05284-9. Epub 2025 Jan 10.
Coronary artery disease (CAD) is the leading cause of death worldwide. Acute coronary syndrome (ACS) encompasses a spectrum of diagnoses ranging from unstable angina pectoris to myocardial infarction with and without ST-segment elevation and frequently presents as the first clinical manifestation. It is crucial in this scenario to perform a timely and comprehensive assessment of patients by evaluating the clinical presentation, electrocardiogram and laboratory diagnostics using highly sensitivity cardiac troponin in order to initiate a timely and risk-adapted continuing treatment with immediate or early invasive coronary angiography. In addition to revascularization, the subsequent antithrombotic and lipid-lowering treatment plays a major role in the further secondary prevention of CAD. The choice and duration of medication over time should be tailored to the individual risk profile of the patient. Furthermore, appropriate patient education regarding risk factor management is of paramount importance.
冠状动脉疾病（CAD）是全球范围内的主要死因。急性冠状动脉综合征（ACS）涵盖了一系列诊断，从不稳定型心绞痛到伴有或不伴有ST段抬高的心肌梗死，并且常作为首发临床表现出现。在这种情况下，通过评估临床表现、心电图以及使用高敏心肌肌钙蛋白进行实验室诊断，对患者进行及时、全面的评估至关重要，以便启动及时且根据风险调整的持续治疗，并立即或尽早进行有创冠状动脉造影。除血运重建外，后续的抗栓和降脂治疗在CAD的进一步二级预防中起着重要作用。随着时间推移，药物的选择和疗程应根据患者的个体风险状况进行调整。此外，针对危险因素管理进行适当的患者教育至关重要。
