Herz
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In November 2009 the first European guidelines were presented regarding preoperative risk assessment and perioperative management in non-cardiac surgery. They were designed by the European Society of Cardiology (ESC) and endorsed by the European Society of Anesthesiology. ⋯ These guidelines are straightforward and feasible for cardiologists as well as specialists in internal medicine and general practicioners. Nevertheless, some points still lack evidence.
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Acute myocardial infarction and its consequences (death, chronic ischemic coronary artery disease, heart failure) are still the number 1 causes of death and of cardiovascular diseases in Germany. In this context, patients with STEMI are at the highest risk. The first-line management of STEMI patients often determines if the outcome is life or death. ⋯ There is no evidence that higher maintenance doses of clopidogrel may circumvent possible clopidogrel resistance. The usefulness of so far non-standardized in-vitro platelet aggregation measurements or the practice-oriented interpretation of genetic tests for CYP2C19 polymorphism is unknown. With the 12 months DAPT the patient is treated not the stent.