血脂与调脂治疗ppt课件.pptVIP

正式源于此，各种指南均推荐将LDL-C作为动脉粥样硬化性疾病重要的干预点，并且做出了越来越积极的推荐。 CRP不但能作为心血管疾病的预测因子，而且能作为评价PCI手术预后的指标。 如图所示的一项前瞻性队列研究中，共入选了727名即将接受PCI手术的患者，评价基线CRP水平（PCI术前水平）与术后30天死亡率或心肌梗死发生率间的关系。结果显示：在CRP水平最低的一组（0.16mg/L），死亡或心肌梗死的发生率为3.9%；在CRP水平最高的一组（1.01mg/L），死亡或心肌梗死的发生率为14.2%；且这种趋势有统计学显著性意义。 鉴于上述结果，作者指出：CRP与PCI术的预后密切相关，这可能会指导未来的治疗策略。 Background—Established methods of risk assessment in percutaneous coronary intervention have focused on clinical and anatomical lesion characteristics. Emerging evidence indicates the substantial contribution of inflammatory processes to short-term and long-term outcomes in coronary artery disease. Methods and Results—Within a single-center registry of contemporary percutaneous coronary revascularization strategies with postprocedural creatine kinase and clinical events routinely recorded, we assessed the association of baseline C-reactive protein with death or myocardial infarction within the first 30 days. Predictive usefulness of baseline C-reactive protein within the context of established clinical and angiographic predictors of risk was also examined. Among 727 consecutive patients, elevated baseline C-reactive protein before percutaneous coronary intervention was associated with progressive increase in death or myocardial infarction at 30 days (lowest quartile, 3.9%, versus highest quartile, 14.2%; P0.002). Among clinical and procedural characteristics, baseline C-reactive protein remained independently predictive of adverse events, with the highest quartile of C-reactive protein associated with an odds ratio for excess 30-day death or myocardial infarction of 3.68 (95% CI, 1.51 to 8.99; P0.004). A predictive model that included baseline C-reactive protein quartiles, American College of Cardiology/American Heart Association lesion score, acute coronary syndrome presentation, and coronary stenting appears strongly predictive of 30-day death or myocardial infarction within this population (C-statistic, 0.735) and among individual patients (Brier score