降似脂与动脉粥样硬化斑块的逆转.ppt

* Aorta 主动脉 Carotid 颈动脉 * Slide 10 The 4S, LIPID and CARE trials demonstrated that long-term intervention with statins therapy reduces mortality and recurrent ischemic cardiovascular events in patients with stable coronary heart disease. The duration of follow-up of these studies was 5.4 years for 4S, 6.1 years for LIPID and 5.0 years for CARE. However, these trials excluded patients who had experienced unstable angina or acute MI within 3 to 6 months prior to randomization [8–10]. In fact, it is within the first few weeks to months following an acute coronary syndrome that patients experience the highest rate of death and recurrent ischemic events. To date, it has not been determined whether initiation of treatment with a statin immediately following an acute coronary syndrome can reduce the occurrence of these early events. The MIRACL study has been design specifically to address this issue [14]. References 8. Scandinavian Simvastatin Survival Study Group. Lancet 1994;344:1383–1389. 9. Sacks FM et al. N Engl J Med 1996;335:1001–1009. 10. The long-term intervention with pravastatin in ischaemic disease (LIPID) study group. N Engl J Med 1998;339:1349–1357. 14. Schwartz GG et al. Am J Cardiol 1998;81:578–581. * 包括了广泛的动脉粥样硬化性血管病的患者。 The HPS enrolled a wide range of patients (n=20,536) in the United Kingdom at high risk for CHD. Between July 1994 and May 1997, 15,454 men and 5082 women were randomized; 5806 patients were 70 years of age or older at entry. Diagnostic criteria overlapped, with 8510 (41%) being post-MI, 4876 (24%) with some other history of CHD, 5963 (29%) with diabetes mellitus, and 7150 (35%) with no history of CHD. Among patients without pre-existing CHD, 3982 had diabetes mellitus, 2701 had peripheral vascular disease, and 1820 had cerebrovascular disease. In addition, 8457 (41%) patients were being treated for hypertension.4 * When major vascular events were examined individually, simvastatin significantly reduced the relative risk of CH