病区斑块逆转理与他汀.pptVIP

小 结 ACS是动脉粥样硬化血栓形成事件的重要临床表现 辛伐他汀对动脉粥样硬化斑块从有创研究到无创研究，有效剂量从20mg到80mg均有一致的治疗益处--稳定和逆转斑块 辛伐他汀与其它他汀药物比，等效降LDL-C剂量，更有效的逆转斑块作用 HDL-C在斑块进展中起重要作用，辛伐他汀可以显著提高胆固醇逆向转运功能，较其它他汀药物更好的改善HDL-C的质和量 2009 国家基本药物目录（307种） 调脂及抗动脉粥样硬化药物 仅辛伐他汀入选 舒降之是唯一入选的原研辛伐他汀,属于甲类一线用药 舒降之20mg*7片/盒 25元 黄金品质 亲民价格 MASS—多中心抗动脉粥样硬化研究 * Slide 20. ARBITER 2: baseline therapies By study design, all participants of ARBITER 2 were already treated with statins, typically simvastatin (93% of patients) at a mean dose of approximately 35 mg/d. The participants also were commonly treated with medications typical of secondary prevention of CHD, including beta-blockers and aspirin in most. Antioxidant vitamins were discontinued to avoid interference with the effects of niacin on increasing apolipoprotein A-I concentrations. Additional abbreviation on slide: ACE = angiotensin-converting enzyme. References: Taylor AJ, Sullenberger LE, Lee HJ, Lee JK, Grace KA. Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol (ARBITER) 2: a double-blind, placebo-controlled study of extended-release niacin on atherosclerosis progression in secondary prevention patients treated with statins. Circulation 2004;110:3512-3517. Cheung MC, Zhao XQ, Chait A, Albers JJ, Brown BG. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol. 2001 Aug;21(8):1320-6. * 在ACS发病后，患者低水平HDL-C的风险何在? 1项新近的研究解答了这个问题。 1,032持续的ACS患者，植入了药物洗脱支架(DES) “低水平HDL-C” (n = 550), 男性 40 mg/dl; 女性 45 mg/dl (均值= 32 +/-7 mg/dl) “正常/高水平HDL-C” (n = 482),男性 40 mg/dl;女性 45 mg/dl (均值= 55+/-19 mg/dl) 终点: 在30天和1年时，发生死亡; Q-波 MI, TLR和MACE Statin使用率很高 (每组均达到98%) 在低水平和高水平HDL组中， LDL-C基本相同(102 108 mg/dl) (P = 0.26) What is the risk of low HDL-C in patients after an ACS episode? A recent study has addressed this question. 1,032 consecutive ACS patients had drug-eluting stents (DES) placed “Low HDL-C” (n = 550), 40 mg/dl in men; 4