课件：高脂血症的治疗.ppt

* Despite efficacy of current standards of care, including achievement of low-density lipoprotein (LDL-C) goals, patients remain exposed to a high residual risk of major macrovascular events This slide shows the main results of the meta-analysis, presented as reduction in risk per 1 mmol/L (approx 40 mg/dL) decrease in LDL-C. Although statin therapy is the cornerstone of dyslipidemia management, lowering LDL-C by 1 mmol/L with statins reduced major coronary events by just 23%, leading to a CV residual risk of 77%. Statin therapy was associated with a significant 12% reduction in all-cause mortality relative to control. This reduction reflected a 19% reduction in death from coronary heart disease, and smaller reductions in deaths from other causes. Statin therapy also produced significant reductions in major cardiovascular events, including a 26% reduction in myocardial infarction, 24% reduction in coronary revascularizations, and a 17% reduction in stroke. Note: RR = relative risk. This is the chance of an event occurring with statin treatment. A figure less than 1 indicates that the chance of an event happening is reduced. P value. Standard scientific practice usually deems a p value of less than 1 in 20 (expressed as p0.05) as statistically significant and a p value of less than 1 in 100 (p0.01) as statistically highly significant. Reference Baigent C et al. Lancet 2005;366:1267–78. * TNT investigated the effects of intensive lipid lowering (LDL-C 100 mg/dL or 2.6 mmol/L) on major CV events in patients with stable CHD (n=10,001). The primary endpoint was nonfatal MI or fatal CHD, stroke or resuscitation following cardiac arrest. Patients who had LDL-C 130 mg/dL (3.4 mmol/L) after a 8-week run-in period of atorvastatin 10 mg were randomized to 80 mg (intensive lipid lowering) or 10 mg (conventional lipid lowering). After a median follow-up of 4.9 years, mean LDL-C levels were 77 mg/dL (2.0 mmol/L) in the 80 mg group and 101 mg/dL in the 10 mg group. The