调脂治疗是逆转冠脉斑块.pptVIP

冠脉斑块消退的调脂治疗策略 冠脉斑块消退的血脂谱变化 斑块内游离胆固醇逆向转运的机制 冠脉斑块消退的调脂治疗目标值 廖玉华，诸骏仁。临床心血管病杂志，2012,28（1）：1-3 调脂治疗最终结果与冠脉粥样斑块消退的比较 与基线比,? p0.05, 组间比 * p0.01 廖玉华，诸骏仁。临床心血管病杂志，2012,28（1）：1-3 -12.5* -0.79%* +8.9% 14.7% 49 -53.2% 60.8 RSV 40mg/d ASTERIOD 0.02 0.001 - 0.06 0.06 0.001 0.001 P值 +2.7* +1.6%* - +5.6% 44.6 -25.2% 110.4 PRV 40mg/d -0.4? +0.2%? - +2.9% 43.1 -46.3% 78.9 ATV 80mg/d REVERSAL 0.01 0.17 0.001 0.01 0.01 0.001 0.001 P值 -6.39* -1.22%* +14.6% +11.3% 50.4 -49.7% 62.6 RSV 40mg/d -4.42* -0.99%* +9.1% +8.7% 48.6 -45.9% 70.2 ATV 80mg/d SATURN TAV变化mm3 PAV变化% Apo-A1变化% HDL-C变化% 最终HDL-C mg/dL LDL-C变化% 最终 LDL-C mg/dL 药物 临床试验 LDL-C促进 斑块进展 ApoA1/HDL-C 促进斑块消退 冠脉斑块消退的调脂治疗策略 改善生活方式 标准治疗 强化治疗 LDL-C100 mg/dL LDL-C70 mg/dL 适度调脂 适度调脂逆转斑块 减少胆固醇流入斑块 LDL-C70-80mg/dl 增加胆固醇流出斑块 HDL-C +8% (45-55 mg/dl) ApoA1+9% (135-150 mg/dl) 廖玉华, 诸骏仁. 临床心血管病杂志, 2010, 26 (1):1-3 廖玉华, 诸骏仁. 临床心血管病杂志, 2012, 28 (1):1-3 ICUH Institute of Cardiology Union Hospital 血脂化验单: TC TG LDL-C ApoA1 HDL-C 减少胆固醇流入斑块 增加胆固醇流出斑块 谢 谢！ Regression extend available exceed consequences ascertain minus the median number of images analyzed in the entire cohort to compensate for differences in segment length between subjects. Aggressive striking regression relatively modest unprecedented, nominal videotape frames Subsequently * * SATURN is a multicentre, randomised, double-blind study in which patients with CAD who were eligible for catheterisation were randomised to rosuvastatin 20 mg or atorvastatin 40 mg daily for 2 weeks. Those with an LDL-C level 3.0 mmol/L and TG 5.65 mmol/L were then re-randomised to receive rosuvastatin 40 mg or atorvastatin 80 mg per day for the next 104 weeks. PAV was assessed by IVUS at the start of the study, and will be re-assessed at the end of the treatment period. Reference Nicholls SJ et al. Impact of statins on progression of atherosclerosis: rationale and design of SATURN (Study of Coronary Atheroma by InTravascular Ultrasound: Effect