抗血小板药物的进展和临床ppt课件.ppt

* 幻灯片26 在CAPRIE 研究中，将波立维和阿司匹林相比较，波立维更有益，相对危险度可降低8.7％。这是在阿司匹林相对于安慰剂可降低相对危险度25 ％的基础上实现的。 根据抗血小板研究者协作组报道的阿司匹林的疗效，在与CAPRIE研究对象相似的人群中每治疗1000例病人，每年可预防19起事件，而波立维可预防24起事件，相比之下可进一步降低事件再发数达 26 ％。 * Slide 9 CURE——主要疗效结果主要终点 (1) 波立维加标准治疗（包括阿司匹林）的心血管性死亡、心梗或脑中风的主要联合终点相对危险度比单纯标准治疗降低了20%（RRR 20% p=0.00009）。 Kaplan-Meier曲线几小时后就开始分离，并在12个月中始终保持分离。 波立维加标准治疗（包括阿司匹林）起效很早（几小时内），且在12个月的治疗期内长期有益。 References The CURE Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with non ST elevation acute coronary syndromes. N Eng J Med August 2001. Sanofi-Synthelabo. 资料备索. * * [XXX] PLATO Study Design The PLATelet inhibition and patient Outcomes (PLATO) is an international, randomized, double-blind, event-driven trial designed to test whether ticagrelor compared with clopidogrel will result in a lower risk of recurrent thrombotic events in a broad patient population with ACS. [James 2009 p. 599 B,C] Patients included those hospitalized for ST-elevation ACS with scheduled primary percutaneous coronary intervention or for non–ST-elevation ACS. [James 2009 p. 602 A] More than 18,000 patients were enrolled and randomly assigned to oral maintenance treatment with ticagrelor 90 mg twice daily or clopidogrel 75 mg once daily as early as possible after the index event. [James 2009 p. 603 A] Patients in the ticagrelor group received a loading dose of 180 mg of ticagrelor. [James 2009 p. 603 A] Patients who did not receive either a loading dose of open-label clopidogrel or clopidogrel or ticlopidine for ≥5 days before randomization received a 300-mg loading dose of clopidogrel. [James 2009 p. 603 A] Otherwise, a maintenance dose of clopidogrel was their first dose [James 2009 p. 603 A] Patients undergoing PCI received an additional 300-mg loading dose of clopidogrel at the discretion of the investigator [James 2009 p. 603 A] All patients received ASA 75 mg to 100 mg daily unless they were intolerant. A loading dose of 325 mg was preferred in aspirin-na?ve patie