斑块研究进展教案分析.pptVIP

* ** 灰度IVUS检查显示他汀对于非闭塞病变可以逆转斑块进展过程，然而，他汀对于闭塞病变是否能够改善斑块成分或冠脉血流，目前仍不清楚 Finally, we assessed the percentage of change in LCBI. We found dramatic reductions in percent LCBI between standard and aggressive treatment groups. LCBI was reduced by 27% per lesion, 25% per 10mm and 22% per 4mm. This is a representative case. Baseline and follow-up angio showed similar diameter stenosis in mid LAD as well as similar plaque burden by IVUS. FFR as shown Baseline LCBI measured 259 for lesion segment and decreased to 177 at follow-up. The worst 10mm and 4mm segment LCBI showed a similar trend. * It is well established that achieving lower LDL-C levels results in a greater reduction in cardiovascular (CV) events; however, there has been uncertainty about the possible side effects that could be associated with achieving very low LDL-C levels This latest analysis from JUPITER showed that patients who achieved very low LDL-C ( 50 mg/dL) with CRESTOR 20 mg had significantly fewer CV events and a similar safety profile to patients not achieving such a low LDL-C. The risk of major CV events was also lower in those achieiving very low LDL-C ( 50 mg/dL) than those not achieving such a low LDL-C (HR 0.49, 95% CI 0.34-0.72, p=0.0003). Although the rate of myalgia was higher in the rosuvastatin group overall than in the placebo group (p=0.015), there was no difference in the rate of occurrence of muscle weakness, myopathy, mood disorders, peripheral neuropathy or cancer and no evidence that achieving LDL-C 50 mg/dL with rosuvastatin was associated with an increase in any of these AEs. Independent predictors of attaining very low LDL-C included older age, lower baseline LDL-C, higher BMI and medication adherence (all p0.0001). References Hsia J et al. Safety and Efficacy of Achieving Very Low Lipoprotein Cholesterol Levels With Rosuvastatin in the JUPITER Trial. Circulation 2009;120 (Suppl): S499-S500; Abs 1422 * 治疗中的血脂和hsCRP水平 参数 阿托伐他汀 (n=519) 瑞舒伐他汀 (n=520) P值 LDL-C(mg/dL) 70.2