他汀时代我国的心血管风险--“剩留”风险？ “双重风险”？-.pptVIP

Thank you! * * * This slide provides a graphic representation of the NCEP ATP III LDL cholesterol goals.1 The goal of therapy in patients with CHD is to reduce LDL cholesterol to 100 mg/dL or lower. Patients with established CHD or other atherosclerotic disease should receive drug therapy when LDL cholesterol levels are 130 mg/dL. The degree of risk should indicate the severity of intervention. For example, NCEP guidelines state that for patients without a history of CHD but who have two or more risk factors (such as smoking and hypertension), LDL should be brought below 130 mg/dL. Less aggressive intervention may be warranted if fewer risk factors are present. The LDL cholesterol cut-off is 160 mg/dL for patients with fewer than two risk factors. Reference 1. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA 2001:285;2486-2497. * 根据《指南》精神，高危人群在血脂边缘升高时要进行调脂治疗，在正常范围内在LDL-C 100mg/dL时也要进行调脂治疗。 高危人群的血脂达标在正常范围以下。 也就是说，血脂边缘升高的高危人群必须进行调脂治疗。血脂降到正常值以下仍然要继续进行治疗，从而使血脂达标。 * * * * Treating to New Targets (TNT) was a prospective study performed to determine the efficacy and safety of lowering LDL-C levels below 100 mg/dL (intensive lipid-lowering therapy) in patients with stable CHD.1 The study enrolled 10,001 patients who were randomly assigned to double-blind therapy with either 10 or 80 mg of atorvastatin daily and were followed for up to 6 years. The primary end point was the occurrence of a first major cardiovascular event, defined as death from CHD, nonfatal, non–procedure-related myocardial infarction (MI), resuscitation after cardiac arrest, or fatal or nonfatal stroke. Intensive lipid lowering with 80 mg/d of atorvastatin provided clinically significant added benefit compared with 10 mg/d of atorvastatin in terms of reduced risk for a major cardiovascular event. The mean LDL-C level during treatment was 77 mg/dL in the group receiving 80 mg/d of atorvastatin and 101 mg/dL in the group receiving 10 mg/d. In the intensively