冠心病他汀课件.ppt

冠心病他汀治疗逐渐脱离基线LDL-C限制，LDL-C水平同样不再是他汀治疗的限制条件。这一观念与ESC-ESA新指南 摒弃血脂适宜水平的观念一致。不在乎血脂水平、血脂数字，而在乎危险分层。如SCORE危险评分。 * Score评分定义？ SCORE chart: 10 year risk of fatal cardiovascular disease (CVD) in populations at low CVD risk based on the following risk factors: age, gender, smoking, systolic blood pressure, and total cholesterol. To convert the risk of fatal CVD to risk of total (fatal + non-fatal) hard CVD, multiply by 3 in men and 4 in women, and slightly less in old people. Note: the SCORE chart is for use in people without overt CVD, diabetes, chronic kidney disease, or very high levels of individual risk factors because such people are already at high risk and need intensive * * * * 图中所示的治疗后LDL-C水平和主要心血管事件之间的关系为Cox回归模型评估得出，其中治疗后LDL-C水平作为持续变量预测值。 对于所有类型的人群，降LDL-C降至所能达到的低水平时，主要心血管事件发生风险显著下降(P.0001)。5组中LDL-C水平越低，事件发生率越低。 对个体部分的主要终点分析显示：冠心病死亡、非致死性非手术相关性心肌梗死、卒中的发生风险随着LDL-C水平的降低而显著降低。 心脏骤停复苏发生例数很少（1-5组分别是6, 7, 7, 5, 4 例），5组中未发现有等效倾向。 Reference 1. LaRosa JC, Grundy SM, Kastelein JJP, Kostis JB, Greten H, for the Treating to New Targets (TNT) Steering Committee and Investigators. Safety and efficacy of atorvastatin-induced very low low-density lipoprotein cholesterol levels in patients with coronary heart disease (a post-hoc analysis of the Treating to New Targets [TNT] study). Am J Cardiol. 2007;100:747-752. Score评分定义？ SCORE chart: 10 year risk of fatal cardiovascular disease (CVD) in populations at low CVD risk based on the following risk factors: age, gender, smoking, systolic blood pressure, and total cholesterol. To convert the risk of fatal CVD to risk of total (fatal + non-fatal) hard CVD, multiply by 3 in men and 4 in women, and slightly less in old people. Note: the SCORE chart is for use in people without overt CVD, diabetes, chronic kidney disease, or very high levels of individual risk factors because such people are already at high risk and need intensive * * * SAP的发病根源——LDL-C； SAP的首要治疗指标——降低LDL-C； 按指南标准使LDL-C达标可以显著降低MACE的发生率；进一步降低LDL-C可以进一步获益 * 该研究的入选患者为1997年1月1日