Drugs
There are drugs that are prescribed as standard for coronary heart disease because they have a positive effect on the progression of the disease. These include platelet aggregation inhibitors and statins. Antiplatelets prevent blood platelets from attaching to the walls of the coronary arteries and forming plaques.
Examples are drugs with active ingredients such as acetylsalicylic acid (Aspirin® protect 100), clopidogrel, prasugrel or ticagrelor. Some studies have shown that these drugs can help to prolong your life and prevent complications such as heart attacks. Statins (for example simvastatin) are drugs that help to maintain favorable blood lipid levels.
They are also colloquially called cholesterol-lowering drugs, and cause less cholesterol, which is absorbed through food, to enter the bloodstream. Depending on the symptoms and other illnesses, other drugs such as beta-blockers or ACE inhibitors can be used. Statins are drugs that lower blood lipid levels by inhibiting HMG-CoA reductase (a metabolic enzyme required for the formation of cholesterol).
One of the most significant risk factors for coronary heart disease is elevated cholesterol levels. To be more precise, elevated LDL levels in particular trigger coronary heart disease. The LDL settles on vessel walls and leads there to the deposition of other cells.
In the course of the disease, calcifications form at these sites and the vessel becomes constricted. By inhibiting the formation of LDL, statins can counteract this development. ASA is the abbreviation for acetylsalicylic acid, also known as aspirin and is by definition an analgesic.
In addition to its pain-inhibiting effect, however, it also has a blood-thinning effect, which makes it suitable for the treatment of coronary heart disease (CHD). For blood clotting in the case of injuries, so-called thrombocytes are activated in the body. These platelets are stored together and thus stop the bleeding.
ASA acts on the thrombocytes and inhibits their aggregation (= accumulation). In coronary heart disease, there are narrowed areas in the coronary arteries. To prevent blood clots from forming at these sites, which then enter the brain, for example, the blood is diluted with drugs such as ASA.
A bypass operation is intended to improve the blood flow in areas of the heart muscle at risk of coronary heart disease with the aid of bypasses. These bypasses lead the blood around the narrowed blood vessels so that the affected heart muscle areas can be well supplied with blood by bypass. The indication for bypass surgery in symptomatic coronary artery disease is primarily when the vasoconstrictions are located at anatomically unfavorable sites, for example very close to a vascular outlet or at vascular sites that branch out.Patients who suffer from diabetes mellitus or renal insufficiency in addition to CHD are sent for bypass surgery more often than for stenting because of the complex vascular constrictions.
In general, coronary bypasses eliminate the angina pectoris (narrow heart) caused by CHD and significantly prolong survival. A stent is a small round wire mesh that can be used to treat coronary artery disease (CAD). A CHD is characterized by the fact that the coronary arteries are narrowed in some places.
As a result, not enough blood can flow through them and the tissue behind them is undersupplied. A stent can be used to widen the narrowed area again. This is normally brought to the heart via a catheter.
The catheter is advanced to the heart either through a vessel in the groin or through a vessel on the forearm. On site, the stent can be placed precisely at the previously diagnosed narrowing. During the procedure, the localization of the stent can be checked by means of X-rays.
Once the stent is placed in the vessel, it is inflated with a small balloon so that it lies against the vessel wall. Due to the firm wire mesh of the stent, the vessel cannot usually constrict again at this point. To further increase the effect, there are stents that are coated with special substances.
These are intended to prevent calcification from forming again. After the stent has been inserted, additional drug treatment with blood thinners such as ASS or clopidogrel must be administered. This prevents the formation of blood clots.
In addition to bypass surgery, patients with conor heart disease may be eligible for a stent under certain circumstances. A stent is a small, tubular metal mesh that is inserted into the affected vessel to keep the vessel open. There are stents that are drug-coated and carry anti-inflammatory and anti-growth drugs to prevent the vascular tissue from proliferating, as well as stents without drugs.
In the case of drug-free stents, the heart patient must take anticoagulant drugs such as acetylsalicylic acid (Aspirin® protect 100) or clopidogrel for at least one year. A stent can be used in patients with more easily located vessels, in straight sections, not directly at branches and vessel outlets. A stent is usually only used in patients with symptomatic coronary artery disease when symptoms limit the quality of life.