2007PCI热点话题-英文课件PPT.ppt

Hot Topics of Percutaneous Coronary Intervention 2007;Is DES Safe? Late Thrombosis;From TCT 2006;Adverse Events (Death Q-wave MI)RAVEL, SIRIUS, E-SIRIUS, C-SIRIUS;From TCT 2006;;;;ARC Proposed Standard Definitions;Stent Thrombosis: FDA Advisory Panel, 8RCT;SCAAR registry results as of 2005;p0.001;p=0.08;p=0.97;Drug-Eluting and Bare Metal Stenting in Massachusetts Matched Risk Differences at 2 years ;Adjusted Death /MITotal cohort;Restenosis at clinically driven re-angiography ;Drug-Eluting and Bare Metal Stenting in Fu Wai Hospital;22% BMS;Baseline Characteristics 1;;;Proportion of DES per Lesion;Freedom from Death (All Patients);Freedom from Death (Excluding AMI);Freedom from MI (All Patients);Freedom from Death or MI (All Patients);Freedom from Definite Thrombosis;Freedom from Definite/Probable Thrombosis;Freedom from Definite/Probable/Possible Thrombosis;Freedom from TLR (All Patients);Freedom from TVR (All Patients);When DES are used for their approved indications, the risk of thrombosis does not outweigh their advantages over BMS in reducing TLR As compared with on-label use, off-label use is associated with increased risks of both early and late stent thrombosis,as well as death or MI;A 65-year old male with CAD, hypertension, MI, Status post x2 stents, RCA, proximal BxVelocity and Cypher distal - 15 months prior to death (traumatic brain injury) ;Taxus Pathology at 6-Months;Discontinuation of Anti-platelet Therapy and Risk for ST;Aalen-Nelson estimate of the cumulative hazard function; Occurrence of Stent Thrombosis ;Summary;关于PCI某些适应证的思考;AMI: Pathophysiology;;ACS: Pathophysiology;;;Stable Coronary Artery Disease;COURAGE: Study design;;No. at risk;COURAGE: Treatment effect on hospitalization for ACS;COURAGE: Treatment effect on angina;Boden WE et al. N Engl J Med. 2007;356:1503-16.;PCI + OMT compared to OMT resulted in: Significantly less use of nitrates at - 1 year (53% vs. 67%) - 3 years (47% vs. 61%) - 5 ye