血脂调整与大脑卒中的预防.ppt

* Notes: There were similar proportional reductions in the risk of first stroke when participants were subdivided according to their baseline LDL and HDL cholesterol levels. * Notes: There were similar proportional reductions in the risk of first stroke when participants were subdivided according to their baseline blood pressure levels. * Notes: There were similar proportional reductions in the risk of first stroke irrespective of treated hypertension or aspirin use at baseline. * Notes: Even during the first year there was a trend toward fewer strokes among those allocated simvastatin. There appeared to be a similar proportional reduction in the risk of stroke during each subsequent year of follow-up (even though, by the end of year 3, about one-sixth of simvastatin-allocated participants had stopped their study treatment and about one-sixth of those allocated placebo had started statin therapy). * Notes: The further reductions in stroke during each year of follow-up lead to continued divergence of the lines in this life-table plot of the effect of simvastatin allocation on the incidence of first stroke (which implies that benefits would increase with longer duration treatment). * Notes: Meta-analysis of the results of the major randomised statin trials indicates a 21% (95% CI 15-27) proportional reduction in the incidence of stroke associated with an average reduction in LDL cholesterol of 1.0 mmol/L (39 mg/dL). The overall result for all studies is weighted according to the estimated average LDL difference and number of strokes in each contributing trial. * * At UCLA in 1994 the first hospital based CHD protocol called the Cardiovascular Hospitalization Artherosclerosis Management Program: CHAMP was initiated. Essentially, patients admitted with chest pain, unstable angina, acute MI, cardiac catheterization, angioplasty, coronary bypass, and ischemic heart disease will be started on treatment during hospitalization and then discharged with evidence based medic