@article{TraubFreyStoerk2023,
  author    = {Traub, Jan and Frey, Anna and St{\"o}rk, Stefan},
  title     = {Chronic neuroinflammation and cognitive decline in patients with cardiac disease: evidence, relevance, and therapeutic implications},
  series = {Life},
  volume    = {13},
  journal   = {Life},
  number    = {2},
  issn      = {2075-1729},
  doi       = {10.3390/life13020329},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304869},
  year      = {2023},
  abstract  = {Acute and chronic cardiac disorders predispose to alterations in cognitive performance, ranging from mild cognitive impairment to overt dementia. Although this association is well-established, the factors inducing and accelerating cognitive decline beyond ageing and the intricate causal pathways and multilateral interdependencies involved remain poorly understood. Dysregulated and persistent inflammatory processes have been implicated as potentially causal mediators of the adverse consequences on brain function in patients with cardiac disease. Recent advances in positron emission tomography disclosed an enhanced level of neuroinflammation of cortical and subcortical brain regions as an important correlate of altered cognition in these patients. In preclinical and clinical investigations, the thereby involved domains and cell types of the brain are gradually better characterized. Microglia, resident myeloid cells of the central nervous system, appear to be of particular importance, as they are extremely sensitive to even subtle pathological alterations affecting their complex interplay with neighboring astrocytes, oligodendrocytes, infiltrating myeloid cells, and lymphocytes. Here, we review the current evidence linking cognitive impairment and chronic neuroinflammation in patients with various selected cardiac disorders including the aspect of chronic neuroinflammation as a potentially druggable target.},
  language  = {en}
}
@article{RauchSalzwedelBjarnasonWehrensetal.2021,
  author    = {Rauch, Bernhard and Salzwedel, Annett and Bjarnason-Wehrens, Birna and Albus, Christian and Meng, Karin and Schmid, Jean-Paul and Benzer, Werner and Hackbusch, Matthes and Jensen, Katrin and Schwaab, Bernhard and Altenberger, Johann and Benjamin, Nicola and Bestehorn, Kurt and Bongarth, Christa and D{\"o}rr, Gesine and Eichler, Sarah and Einwang, Hans-Peter and Falk, Johannes and Glatz, Johannes and Gielen, Stephan and Grilli, Maurizio and Gr{\"u}nig, Ekkehard and Guha, Manju and Hermann, Matthias and Hoberg, Eike and H{\"o}fer, Stefan and Kaemmerer, Harald and Ladwig, Karl-Heinz and Mayer-Berger, Wolfgang and Metzendorf, Maria-Inti and Nebel, Roland and Neidenbach, Rhoia Clara and Niebauer, Josef and Nixdorff, Uwe and Oberhoffer, Renate and Reibis, Rona and Reiss, Nils and Saure, Daniel and Schlitt, Axel and V{\"o}ller, Heinz and K{\"a}nel, Roland von and Weinbrenner, Susanne and Westphal, Ronja},
  title     = {Cardiac rehabilitation in German speaking countries of Europe — evidence-based guidelines from Germany, Austria and Switzerland LLKardReha-DACH — Part 1},
  series = {Journal of Clinical Medicine},
  volume    = {10},
  journal   = {Journal of Clinical Medicine},
  number    = {10},
  issn      = {2077-0383},
  doi       = {10.3390/jcm10102192},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239709},
  year      = {2021},
  abstract  = {Background: Although cardiovascular rehabilitation (CR) is well accepted in general, CR-attendance and delivery still considerably vary between the European countries. Moreover, clinical and prognostic effects of CR are not well established for a variety of cardiovascular diseases. Methods: The guidelines address all aspects of CR including indications, contents and delivery. By processing the guidelines, every step was externally supervised and moderated by independent members of the "Association of the Scientific Medical Societies in Germany" (AWMF). Four meta-analyses were performed to evaluate the prognostic effect of CR after acute coronary syndrome (ACS), after coronary bypass grafting (CABG), in patients with severe chronic systolic heart failure (HFrEF), and to define the effect of psychological interventions during CR. All other indications for CR-delivery were based on a predefined semi-structured literature search and recommendations were established by a formal consenting process including all medical societies involved in guideline generation. Results: Multidisciplinary CR is associated with a significant reduction in all-cause mortality in patients after ACS and after CABG, whereas HFrEF-patients (left ventricular ejection fraction <40\%) especially benefit in terms of exercise capacity and health-related quality of life. Patients with other cardiovascular diseases also benefit from CR-participation, but the scientific evidence is less clear. There is increasing evidence that the beneficial effect of CR strongly depends on "treatment intensity" including medical supervision, treatment of cardiovascular risk factors, information and education, and a minimum of individually adapted exercise volume. Additional psychologic interventions should be performed on the basis of individual needs. Conclusions: These guidelines reinforce the substantial benefit of CR in specific clinical indications, but also describe remaining deficits in CR-delivery in clinical practice as well as in CR-science with respect to methodology and presentation.},
  language  = {en}
}
@article{WernerChenRoweetal.2018,
  author    = {Werner, Rudolf A. and Chen, Xinyu and Rowe, Steven P. and Lapa, Constantin and Javadi, Mehrbod S. and Higuchi, Takahiro},
  title     = {Moving into the Next Era of PET Myocardial Perfusion Imaging - Introduction of Novel \(^{18}\)F-labeled Tracers},
  series = {The International Journal of Cardiovascular Imaging},
  journal   = {The International Journal of Cardiovascular Imaging},
  issn      = {1569-5794},
  doi       = {10.1007/s10554-018-1469-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-169134},
  year      = {2018},
  abstract  = {The heart failure (HF) epidemic continues to rise with coronary artery disease (CAD) as one of its main causes. Novel concepts for risk stratification to guide the referring cardiologist towards revascularization procedures are of significant value. Myocardial perfusion imaging (MPI) using single-photon emission computed tomography (SPECT) agents has demonstrated high accuracy for the detection of clinically relevant stenoses. With positron emission tomography (PET) becoming more widely available, mainly due to its diagnostic performance in oncology, perfusion imaging with that modality is more practical than in the past and overcomes existing limitations of SPECT MPI. Advantages of PET include more reliable quantification of absolute myocardial blood flow, the routine use of computed tomography for attenuation correction, a higher spatiotemporal resolution and a higher count sensitivity. Current PET radiotracers such as rubidium-82 (half-life, 76 sec), oxygen-15 water (2 min) or nitrogen-13 ammonia (10 min) are labeled with radionuclides with very short half-lives, necessitating that stress imaging is performed under pharmacological vasodilator stress instead of exercise testing. However, with the introduction of novel 18F-labeled MPI PET radiotracers (half-life, 110 min), the intrinsic advantages of PET can be combined with exercise testing. Additional advantages of those radiotracers include, but are not limited to: potentially improved cost-effectiveness due to the use of pre-existing delivery systems and superior imaging qualities, mainly due to the shortest positron range among available PET MPI probes. In the present review, widely used PET MPI radiotracers will be reviewed and potential novel 18F-labeled perfusion radiotracers will be discussed.},
  subject      = {Positronenemissionstomografie},
  language  = {en}
}
@article{MorbachWagnerGuentneretal.2017,
  author    = {Morbach, Caroline and Wagner, Martin and G{\"u}ntner, Stefan and Malsch, Carolin and Oezkur, Mehmet and Wood, David and Kotseva, Kornelia and Leyh, Rainer and Ertl, Georg and Karmann, Wolfgang and Heuschmann, Peter U and St{\"o}rk, Stefan},
  title     = {Heart failure in patients with coronary heart disease: Prevalence, characteristics and guideline implementation - Results from the German EuroAspire IV cohort},
  series = {BMC Cardiovascular Disorders},
  volume    = {17},
  journal   = {BMC Cardiovascular Disorders},
  number    = {108},
  doi       = {10.1186/s12872-017-0543-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-157738},
  year      = {2017},
  abstract  = {Background: Adherence to pharmacotherapeutic treatment guidelines in patients with heart failure (HF) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aim was to investigate prevalence and characteristics of HF in patients with coronary heart disease (CHD), and to assess the adherence to current HF guidelines in patients with HF stage C, thus identifying potential targets for the optimization of guideline implementation. Methods: Patients from the German sample of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EuroAspire) IV survey with a hospitalization for CHD within the previous six to 36 months providing valid data on echocardiography as well as on signs and symptoms of HF were categorized into stages of HF: A, prevalence of risk factors for developing HF; B, asymptomatic but with structural heart disease; C, symptomatic HF. A Guideline Adherence Indicator (GAI-3) was calculated for patients with reduced (≤40\%) left ventricular ejection fraction (HFrEF) as number of drugs taken per number of drugs indicated; beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and mineralocorticoid receptor antagonists (MRA) were considered. Results: 509/536 patients entered analysis. HF stage A was prevalent in n = 20 (3.9\%), stage B in n = 264 (51.9\%), and stage C in n = 225 (44.2\%) patients; 94/225 patients were diagnosed with HFrEF (42\%). Stage C patients were older, had a longer duration of CHD, and a higher prevalence of arterial hypertension. Awareness of pre-diagnosed HF was low (19\%). Overall GAI-3 of HFrEF patients was 96.4\% with a trend towards lower GAI-3 in patients with lower LVEF due to less thorough MRA prescription. Conclusions: In our sample of CHD patients, prevalence of HF stage C was high and a sizable subgroup suffered from HFrEF. Overall, pharmacotherapy was fairly well implemented in HFrEF patients, although somewhat worse in patients with more reduced ejection fraction. Two major targets were identified possibly suited to further improve the implementation of HF guidelines: 1) increase patients´ awareness of diagnosis and importance of HF; and 2) disseminate knowledge about the importance of appropriately implementing the use of mineralocorticoid receptor antagonists. Trial registration: This is a cross-sectional analysis of a non-interventional study. Therefore, it was not registered as an interventional trial.},
  language  = {en}
}
@article{GybergDeBacquerDeBackeretal.2015,
  author    = {Gyberg, Viveca and De Bacquer, Dirk and De Backer, Guy and Jennings, Catriona and Kotseva, Kornelia and Mellbin, Linda and Schnell, Oliver and Tuomilehto, Jaakko and Wood, David and Ryden, Lars and Amouyel, Philippe and Bruthans, Jan and Conde, Almudena Castro and Cifkova, Renata and Deckers, Jaap W. and De Sutter, Johan and Dilic, Mirza and Dolzhenko, Maryna and Erglis, Andrejs and Fras, Zlatko and Gaita, Dan and Gotcheva, Nina and Goudevenos, John and Heuschmann, Peter and Laucevicius, Aleksandras and Lehto, Seppo and Lovic, Dragan and Milicic, Davor and Moore, David and Nicolaides, Evagoras and Oganov, Raphae and Pajak, Andrzej and Pogosova, Nana and Reiner, Zeljko and Stagmo, Martin and St{\"o}rk, Stefan and Tokg{\"o}zoglu, Lale and Vulic, Dusko},
  title     = {Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology},
  series = {Cardiovascular Diabetology},
  volume    = {14},
  journal   = {Cardiovascular Diabetology},
  number    = {133},
  doi       = {10.1186/s12933-015-0296-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-141358},
  year      = {2015},
  abstract  = {Background: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. Methods: A total of 6187 patients (18-80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012-2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. Results: A total of 2846 (46 \%) patients had no diabetes, 1158 (19 \%) newly diagnosed diabetes and 2183 (35 \%) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60 \%, respectively. A blood pressure target of <140/90 mmHg was achieved in 68, 61, 54 \% and a LDL-cholesterol target of <1.8 mmol/L in 16, 18 and 28 \%. Patients with newly diagnosed and previously known diabetes reached an HbA1c <7.0 \% (53 mmol/mol) in 95 and 53 \% and 11 \% of those with previously known diabetes had an HbA1c >9.0 \% (>75 mmol/mol). Of the patients with diabetes 69 \% reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (approximate to 40 \%) and only 27 \% of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. Conclusions: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease.},
  language  = {en}
}
@article{FruchartDavignonHermansetal.2014,
  author    = {Fruchart, Jean-Charles and Davignon, Jean and Hermans, Michael P. and Al-Rubeaan, Khalid and Amarenco, Pierre and Assmann, Gerd and Barter, Philip and Betteridge, John and Bruckert, Eric and Cuevas, Ada and Farnier, Michel and Ferrannini, Ele and Fioretto, Paola and Genest, Jacques and Ginsberg, Henry N. and Gotto Jr., Antonio M. and Hu, Dayi and Kadowaki, Takashi and Kodama, Tatsuhiko and Krempf, Michel and Matsuzawa, Yuji and N{\´u}{\~n}ez-Cort{\´e}s, Jes{\´u}s Mill{\´a}n and Monfil, Calos Calvo and Ogawa, Hisao and Plutzky, Jorge and Rader, Daniel J. and Sadikot, Shaukat and Santos, Raul D. and Shlyakhto, Evgeny and Sritara, Piyamitr and Sy, Rody and Tall, Alan and Tan, Chee Eng and Tokg{\"o}zoğlu, Lale and Toth, Peter P. and Valensi, Paul and Wanner, Christoph and Zambon, Albertro and Zhu, Junren and Zimmet, Paul},
  title     = {Residual macrovascular risk in 2013: what have we learned?},
  series = {Cardiovascual Diabetology},
  volume    = {13},
  journal   = {Cardiovascual Diabetology},
  number    = {26},
  issn      = {1475-2840},
  doi       = {10.1186/1475-2840-13-26},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-117546},
  year      = {2014},
  abstract  = {Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R(3)i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R(3)i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R(3)i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptor alpha agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R(3)i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk.},
  language  = {en}
}
@phdthesis{Stein2011,
  author    = {Stein, Sylvia},
  title     = {Hemmung der Mobilisation und Funktion humaner endothelialer Vorl{\"a}uferzellen durch den endogenen NO-Synthase-Inhibitor asymmetrisches Dimethylarginin (ADMA) bei koronarer Herzkrankheit},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-57317},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2011},
  abstract  = {Intaktes Endothel und die ausreichende Funktion der endothelialen NO-Synthase (eNOS) sind Voraussetzungen f{\"u}r gesunde Gef{\"a}ße. Eine endotheliale Dysfunktion besteht bei Patienten mit kardiovaskul{\"a}ren Risikofaktoren bzw. manifester koronarer Herzerkrankung (KHK). Endotheliale Vorl{\"a}uferzellen (EPC) sind ein wichtiger Faktor f{\"u}r die Aufrechterhaltung der Hom{\"o}ostase des Endothels. Im klinischen Teil der vorliegenden Arbeit konnte gezeigt werden, dass diese Vorl{\"a}uferzellen mit zunehmender Schwere der KHK in geringerem Maß im Blut zirkulieren. Die Anzahl der EPC war bei Patienten mit einer koronaren 3-Gef{\"a}ßerkrankung um 77 \% geringer, die Anzahl der kolonie-bildenden Einheiten (CFUs) um 50,3\%, jeweils verglichen mit Patienten ohne KHK. Bei diesen Patienten konnte ebenfalls gezeigt werden, dass sich die Konzentration des endogenen eNOS-Inhibitors asymmetrisches Dimethylarginin (ADMA) im Plasma mit zunehmender Schwere der KHK erh{\"o}hte (0,47 ± 0,02 μmol/l bei fehlender KHK gegen{\"u}ber 0,58 ± 0,02 μmol/l bei koronarer 3-Gef{\"a}ßerkrankung). ADMA ist {\"u}ber eine Hemmung der eNOS an der Entstehung und Aufrechterhaltung einer endothelialen Dysfunktion beteiligt. {\"U}ber diesen Weg wird vermutlich auch die Funktion der EPC erheblich eingeschr{\"a}nkt. Dies konnten wir anhand der In­vitro­Versuche mit EPC gesunder Spender zeigen. Dabei reduzierte sich unter ADMA-Einfluß die Anzahl der EPC in Kultur, die Anzahl und Gr{\"o}ße der CFUs und ihre Funktion bzw. ihre F{\"a}higkeit, sich in gef{\"a}ß{\"a}hnliche Strukturen zu integrieren. Eine gleichzeitige Gabe des HMG-CoA-Reduktase-Inhibitors Rosuvastatin wirkte in all diesen In-vitro-Versuchen der hemmenden Wirkung von ADMA entgegen. Die vorliegende Arbeit zeigt erstmals eine inverse Korrelation zwischen ADMA-Spiegeln und der Anzahl und Funktion der EPC. Der negative Einfluss auf EPCs ist vermutlich ein wichtiger Mechanismus, {\"u}ber den ADMA der Entstehung und dem Fortschreiten kardiovaskul{\"a}rer Erkrankungen Vorschub leistet.},
  subject      = {endotheliale Vorl{\"a}uferzellen},
  language  = {de}
}
@phdthesis{Kaufmann2010,
  author    = {Kaufmann, Dana},
  title     = {Neurologische Defizite bei Patienten mit der Diagnose KHK zu Beginn und am Ende der Anschlussheilbehandlung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-55153},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2010},
  abstract  = {Das Auftreten neurologischer Defizite bei Patienten mit der Diagnose Koronare Herzkrankheit (KHK) ist bekannt. Als Ursachen werden lange Isch{\"a}miezeiten und Mikroluftembolien (Bubbles) w{\"a}hrend einer Aorto-Koronaren-Venenbypass- Operation (ACVB-Operation) angenommen Patienten, die der kardiologischen Intervention mittels Perkutaner Transluminaler Koronarer Angioplastie (PTCA / PCI) zugef{\"u}hrt werden, zeigen ebenfalls neurologische Defizite. Bisher waren neurokognitive Ver{\"a}nderungen in der kardiologischen Rehabilitation nur Gegenstand sehr weniger Studien. {\"U}ber den zeitlichen Verlauf w{\"a}hrend der Anschlussheilbehandlung (AHB) wurden noch keine Untersuchungen durchgef{\"u}hrt. Aus diesem Grund besch{\"a}ftigt sich diese Arbeit mit der Testung des neurologischen Status der Patienten mit einer KHK bei Aufnahme und Entlassung aus der Rehabilitation. Es sollte gekl{\"a}rt werden, ob und in welchem Ausmaß kognitive Defizite bestehen und wie sich diese {\"u}ber den Zeitraum der Rehabilitation ver{\"a}ndern. Dazu sieht die Studie einen Vergleich zwischen zwei Kohorten vor. Die erste Gruppe setzt sich aus Patienten zusammen, die mittels PTCA versorgt wurden. Die zweite Gruppe schließt einer ACVB-Operation zugef{\"u}hrte Herzpatienten ein. Dass KHK-Patienten neurokognitive Defizite aufweisen hat sich in den Studienergebnissen best{\"a}tigt. Sowohl die PCI-Kohorte, als auch die ACVB-Gruppe zeigte bei Aufnahme neurokognitive Leistungseinschr{\"a}nkungen in Form unterdurchschnittlicher Testergebnisse. Die Hypothese, dass im Rahmen einer AHB eine Verminderung neurokognitiver Leistungseinschr{\"a}nkungen und bessere Testresultate bei Entlassung erzielt werden, wurde widerlegt. Die Annahme, dass PCI-Patienten geringere kognitive Defizite und bessere Testleistungen bei Aufnahme und Entlassung verzeichnen als ACVB-Patienten trifft nicht zu. Die Vermutung, dass ACVB-Patienten ausgepr{\"a}gtere neurologische Leistungseinschr{\"a}nkungen und schlechtere Testresultate bei Aufnahme und Entlassung aufzeigen, hat sich nicht bewahrheitet.},
  subject      = {neurologische Defizite},
  language  = {de}
}
@phdthesis{Weinberger2010,
  author    = {Weinberger, Sarah},
  title     = {Die konventionelle Pl{\"a}ttchenaggregometrie untersch{\"a}tzt das unzureichende Ansprechen auf Clopidogrel bei KHK-Patienten im Vergleich zu einem P2Y12-spezifischen Test},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-47824},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2010},
  abstract  = {Die koronare Herzkrankheit ist die h{\"a}ufigste Todesursache in Industrienationen und wird mit Zunahme ihrer Risikofaktoren in Zukunft weiter an Bedeutung gewinnen. Seitdem große Studien zeigen konnten, dass KHK-Patienten von der Behandlung mit dem Thrombozytenaggregationshemmer Clopidogrel profitieren, ist das Thienopyridin Bestandteil der leitliniengerechten Therapie der akuten und chronischen KHK. In den letzten Jahren fanden Forscher jedoch heraus, dass individuelle Unterschiede in der Wirksamkeit von Clopidogrel existieren, die bei Nonrespondern mit einem erh{\"o}hten kardiovaskul{\"a}ren Risiko einhergehen. Zur Beurteilung der Relevanz eines verminderten Ansprechens auf Clopidogrel in einem allt{\"a}glichen Patientenkollektiv wurde aktuell die Thrombozytenaktivit{\"a}t von 100 konsekutiven Patienten mit stabiler KHK untersucht, die mit mindestens 75 mg Clopidogrel t{\"a}glich behandelt wurden. Neben dem P2Y12-spezifischen PRI kam dazu auch die Messung der Verschlusszeit im PFA-100®, die ADP-induzierte P-Selektin-Expression und der aktuelle Goldstandard der Thrombozytenaktivit{\"a}tsmessung, die ADP-induzierte Pl{\"a}ttchenaggregometrie, zum Einsatz. Trotz guter Korrelation der Ergebnisse von PRI und Aggregometrie, war die Rate der Nonresponder mit einem PRI > 50\% deutlich h{\"o}her als in der Aggregometrie. Insgesamt fand sich bei 69\% der Patienten ein unzureichendes Ansprechen auf Clopidogrel. 39\% der Clopidogrel-Nonresponder konnten in der Aggregometrie nicht als solche detektiert werden. In der statistischen Analyse zeigten sich niedrige HDL-Spiegel und eine Hypercholesterin{\"a}mie in der Vorgeschichte als Einflussfaktoren der Clopidogrel-Nonresponsiveness. Andere kardiovaskul{\"a}re Risikofaktoren, Komorbidit{\"a}ten und Medikamente hatten keine Auswirkung auf die Clopidogrel-Responsiveness. Die Problematik der Clopidogrel-Nonresponsiveness bedarf vor allem wegen der Korrelation mit klinischen Ereignissen und der erh{\"o}hten Mortalit{\"a}t einer baldigen L{\"o}sung. In Frage kommen dazu der Einsatz neuer Substanzen und eine generelle oder individuelle Dosisanpassung. Unklar ist allerdings noch, welches Konzept am sichersten und {\"o}konomischsten ist. Aktuell ist besonders bei Hochrisikopatienten eine Testung der Clopidogrel-Responsiveness mit individueller Dosisanpassung sinnvoll. Aufgrund der h{\"o}heren Sensitivit{\"a}t im Vergleich zur Pl{\"a}ttchenaggregometrie w{\"a}re ein P2Y12-spezifischer Test {\"a}hnlich dem PRI dazu am ehesten geeignet.},
  subject      = {Clopidogrel},
  language  = {de}
}
@phdthesis{Bluemm2009,
  author    = {Bl{\"u}mm, Annabelle},
  title     = {Die klinische Wertigkeit von "High-Molecular-Weight" Adiponektin bei der Koronaren Herzkrankheit - Untersuchungen zur Rolle eines neuen kardiovaskul{\"a}ren Risikopr{\"a}diktors und dessen pharmakologischer Beeinflussung durch Atorvastatin},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-48143},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2009},
  abstract  = {Adiponektin, ein Hormon des Fettgewebes, besitzt antiatherosklerotische Effekte und niedrige zirkulierende Adiponektin-Spiegel sind mit Koronarer Herzkrankheit (KHK) assoziiert. Der High-molecular weight (HMW)-Adiponektin Komplex wird als die bioaktive Komponente von Adiponektin vermutet. Frage dieser Studie war, ob HMW-Adiponektin mit dem Ausmaß einer KHK korreliert und ob HMW eher als Pr{\"a}diktor f{\"u}r das Ausmaß einer KHK verwendet werden kann als Gesamtadiponektin. Eine weitere Studie zielte auf die m{\"o}gliche therapeutische Beeinflussung der multimeren Zusammensetzung von Adiponektin mittels Atorvastatin.},
  subject      = {Koronare Herzkrankheit},
  language  = {de}
}