(美卡素)心血管保护的最新临床证据5.pptVIP

ONTARGET试验计划 ONTARGET研究的终点 一级终点： 心血管死亡、心肌梗死、卒中及因心力衰竭住院 与HOPE研究基本一致 二级终点： 再次血运重建术、因心绞痛住院、新发或恶化心绞痛、新诊断糖尿病、心力衰竭、新发房颤、肾功能受损及透析 RAS阻断剂降压以外作用：肾保护 阻断RAAS系统的主要目的是延缓CKD的进程 ACEI/ ARB对肾功能的保护比其它降压药物更好 两类药物都能减少蛋白尿，小型临床研究表明两药联合更好 两类药物联合应能更好地保护或改善肾功能 Systematic review: ACEI/ARB抗蛋白尿作用 ARBs and ACE inhibitors were similarly effective at lowering proteinuria a combination of ARBs and ACE inhibitors was more effective than either agent alone we know far too little about their long-term safety, especially with combination therapy of ACE inhibitors plus ARBs in stage 3 or 4 chronic kidney disease. (A) p