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Mini-Review

Personalisierte Therapie des chronischen Koronarsyndroms

Published Online:March 02, 2022https://doi.org/10.1024/1661-8157/a003802

Abstract

Zusammenfassung. Das chronische Koronarsyndrom stellt eine der häufigsten Erkrankungen dar. Die durch das chronische Koronarsyndrom bedingte myokardiale Ischämie kann sowohl durch morphologische wie auch funktionelle Veränderungen der Herzkranzgefässe bedingt sein, wobei Veränderungen das epikardiale Koronarsystem oder die koronare Mikrozirkulation betreffen können. Zur Abklärung von Personen mit Verdacht auf ein chronisches Koronarsyndrom werden nicht-invasive und invasive diagnostische Verfahren eingesetzt. Lebensstilveränderungen, optimale medikamentöse Therapie und die koronare Revaskularisation stellen die Hauptpfeiler in der Behandlung von Patientinnen und Patienten mit chronischem Koronarsyndrom dar. Der vorliegende Übersichtsartikel fasst die unterschiedlichen Formen des chronischen Koronarsyndroms zusammen und diskutiert Diagnostik und Therapie von Menschen mit chronischem Koronarsyndrom. Insbesondere wird der Stellenwert der perkutanen koronaren Revaskularisation in der Behandlung des chronischen Koronarsyndroms erörtert.


Personalized Therapeutic Concepts in Chronic Coronary Syndromes

Abstract. Chronic coronary syndromes (CCS) are related to substantial morbidity and mortality. Myocardial ischemia in CCS is caused by either obstructive or non-obstructive alterations of the coronary arteries, including both morphological and functional changes of epicardial vessels and the coronary microvasculature. Diagnostic algorithms of patients with suspected CCS include non-invasive and invasive imaging and functional testing. Therapeutic management comprises lifestyle changes, optimal medical therapy, and coronary revascularization when indicated. This review summarizes the contemporary management of patients with CCS, focusing on the role of invasive assessment and treatment.


Traitement personnalisé du syndrome coronarien chronique

Résumé. Le syndrome coronarien chronique est une des cardiomyopathies les plus fréquentes. L’ischémie myocardique causée par le syndrome coronarien chronique peut résulter en des changements dans la morphologie comme dans la fonction des artères coronaires qui peuvent affecter le système coronaire épicardique ou la microcirculation coronaire. Le dépistage des patients soupçonnés d’avoir un syndrome coronarien chronique s’effectue par des méthodes de diagnostic invasives et non-invasives. Le traitement des patients souffrant de syndrome coronarien chronique se base sur des changements du mode de vie, un traitement médicamenteux optimal et une revascularisation coronarienne. L’article présente une synthèse des différentes formes de syndrome coronarien chronique et discute le diagnostic et la thérapie des patients qui en sont atteints. L’importance élevée de revascularisation coronarienne percutanée dans le traitement du syndrome coronarien chronique fait en particulier l’objet de la discussion.

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