CVD 防治的风向标.ppt 北大维信.pptVIP

* * 正是基于血脂康多年来扎实的基础与临床研究，由中国医师协会心血管医师分会牵头，由中国医师协会心血管内科医师分会,中国老年医学会心脑血管病专业委员会,中国医师协会循证医学专业委员会,《心血管疾病防治中国专家共识》编委会共同组织国内多领域权威专家制定了《血脂康胶囊临床应用中国专家共识》，完整总结了血脂康多年来的研究与应用。 * * 共识中专家推荐临床使用血脂康胶囊的适应证如下：1用于轻、中度胆固醇升高患者；2治疗以胆固醇升高为主的混合性血脂异常；3用于TG轻度升高及高密度脂蛋白降低的患者；4用于冠心病的二级预防，也可用于血脂水平边缘升高或不高的冠心病患者；5用于高危患者的调脂治疗，治疗糖尿病、高血压、代谢综合征及老年人群的血脂异常；6试用于其他他汀类药物不能耐受或引起肝酶和肌酶升高的血脂异常患者。 * * 2007年6个强化降脂研究(2个ACS研究, 4个稳定性冠心病研究)荟萃分析显示. 与常规剂量他汀相比, 大剂量他汀可以降低ACS患者的总死亡率. 但对于稳定性冠心病患者, 不能降低总死亡率. * * Framingham研究显示：在CHD组中,TC、LDL-C水平随着病变支数的增加而增加,HDL-C水平则相反。 * * 高HDL-C发生冠脉事件几率与低HDL-C使用他汀治疗后发生冠脉几率相当。 * * ACCESS Medical Group * TG Level Remains CVD Risk Factor in Patients Treated With Statins: CARE and LIPID Although statins reduce LDL-C and CVD risk, statins do not eliminate the CVD risk associated with high TGs. The CVD event rates (CHD death, nonfatal MI, percutaneous transluminal coronary angioplasty [PTCA], and coronary artery bypass grafting [CABG]), from the pooled analysis of CARE and LIPID (N = 13,173) are plotted according to quintiles of baseline TG levels. Lines are best fit linear regressions with entire range of baseline TG concentrations. The high CVD risk associated with a high TG level is not eliminated by statin therapy. * * ACCESS Medical Group * BIP: Primary End Point in Patients With Baseline TG ? 200 mg/dL and 200 mg/dL In the BIP trial, bezafibrate reduced the crude primary end point rate (fatal and nonfatal MI and sudden death) in a direct relationship with the level of baseline TGs. “Among patients with baseline TGs ? 200 mg/dL (225 patients in the placebo group and 234 in the bezafibrate treatment group), bezafibrate reduced the cumulative probability of a primary end point by 39.5% (P = 0.02), while in patients with baseline TGs 200 mg/dL (1317 patients in the placebo group and 1314 patients in the bezafibrate treatment group), the reduction in cumulative probability of an end point was not significant.”1 ? Reference 1. The BIP Study Group. Secondary prevention by raising HDL choles