(精选)【高血压英文课件精品课件】 Primary Care Today Educational Conference and Medical Exposition教学课件.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Approximately 1 in 5 patients with PAD will experience CV death, MI, stroke, or hospitalization within 1 year Breakdown of event rates PAD CAD CVD ????? ?????? ??????? 21.1% 1 in ~5 15.2% 1 in ~6 14.5% 1 in ~7 Steg PG et al, on behalf of the REACH Registry Investigators. JAMA 2007;297(11):1197-1206. Take-Home Messages Take-Home Messages (continued) ~ 60% of patients with PAD have diffuse vascular disease ~ 15% of patients with PAD will require a vascular intervention at 1 year Lifelong antiplatelet therapy with ASA or clopidogrel is recommended for patients with PAD Adherence to guideline recommendations may lead to reduced mortality in PAD * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Question 5 Which of the following in NOT appropriate Anti-platelet therapy for Louise? ER Dipyrdamole 200 mg plus ASA 25 mg BID ECASA 81 mg plus clopidogrel 75 mg OD ECASA 81 - 325 mg OD alone Clopidogrel 75 mg OD alone None of the above, all are reasonable ? MATCH: Results Cumulative Event Rate (Ischemic Stroke, MI, Vascular Death, Rehospitalization due to Ischemic Event) Months of follow-up 6.4% RRR 1.03% ARR P=0.244 0 6 12 18 0 1 3 6 12 18 Cumulative event rate (%) Placebo ASA On-Treatment Analysis: 9.6% RRR, 1.6% ARR, p=0.10 * All patients received clopidogrel background therapy Diener HC, et al. Lancet. 2004; 364:331-337. ESPS 2:Risk Reduction for Stroke or Death Stroke relative risk reduction (%) P0.001 P0.05 P0.05 P=0.006 ER DP = extended release dipyridamole n = 6602 within 3 months of stroke or TIA 2 years of follow-up Diener HC, et al. J Neurol Sci. 1996;143:1-13. Antithrombotic Trialists’ Collaboration ASA dose 500 – 1500 mg daily 160 – 325 mg daily 75 – 150 mg daily 75 mg daily Any ASA dose 0.0 0.5 1.0 1.5 ASA better Control better % odds reduction* Antithrombotic Trialists’ Collaboration. BMJ. 2002;324:71-86. 23% + 2 (P0.0001) *Vascular events = MI, stroke or va