房颤双重抗血小板相关治疗预防卒中的新契机.ppt

卒中风险评估和分层防治论坛;房颤双重抗血小板治疗预防卒中的新契机－ACTIVE A的启示;房颤与卒中的发生;不同国家的房颤患病率;房颤患者卒中危险分层;Background Average stroke rate of 5% per year Aspirin reduces stroke（RR 0.78）in patients with non-valvular AF1 Warfarin（INR 2.0-3.0）is more effective than aspirin at reducing stroke（RR 0.36; 95%CI 0.26-0.51）1 Combination of aspirin and clopidogrel is less effective than warfarin and has a similar bleeding rate2;Background Anticoagulation with an INR below 2.0 is not effective Increased risk for bleeding complications with an INR 3.5 Patients 65 years of age with “lone AF” (without other risk factors) are at low risk, whereas patients older than 65 years are at a higher risk for embolic stroke Anticoagulation can be safe and effective in older individuals1, 2 ;维生素K拮抗剂用于房颤;中国AF患者抗凝治疗的现状;抗血小板治疗用于AF患者;ACTIVE研究的设计与流程;ACTIVE W 研究;ACTIVE A 研究结果;ACTIVE A入组情况的因素;研究总结;;氯吡格雷加ASA与单用ASA相比，可显著减少11%的血管事件相对风险;在卒中方面的获益最大;一级和二级终点; 结局;出血的定义;出血率;大出血的主要部位;一级疗效终点 vs.一级安全性终点;理解ACTIVE A和ACTIVE W;获益和风险：与华法林相比;ACTIVE A和W：卒中率和风险降低;按照Rankin评分的卒中严重程度;ACTIVE A的临床启示;备用幻灯;亚组分析 – 一级终点各亚组间基本一致;亚组分析 – 卒中各亚组间基本一致