血小板GPIIbIIIa受体拮抗剂40053精编PPT课件.pptVIP

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血小板GPIIbIIIa受体拮抗剂40053精编PPT课件.ppt

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* 5833例UA患者48小时内行PCI术,在导管室前接受早期GPIIb/IIIa治疗的患者，住院期间的事件有减少的趋势。 This is an observational study from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) registry. This slide makes the point that for in-hospital events there was a trend toward reduced events among those who received GP IIb/IIIa inhibitors prior to proceeding to the catheterization lab.1 1. Peterson E. CRUSADE registry data. Presented at: ACC 52nd Annual Scientific Session; March 30–April 2, 2003; Chicago, Il. * Chew DP.Circulation 2001 Unfractionated Heparin:relationship between ACT,Efficacy and BLEEDING in PCI Revasc Revascularization * The task force concluded that substantial evidence exists that patients receiving LMWH for UA/NSTEMI can safely undergo cardiac catheterization and PCI. In addition, they suggested that possible concerns regarding the transition of UA/NSTEMI patients from the medical service to the cardiac catheterization laboratory should not impede the upstream use of LMWH. Finally, they concluded that LMWH and GP IIb/IIIa receptor antagonists can be used safely in combination, with no apparent increase in the risk of major bleedingAn algorithm was formulated to guide procedural anticoagulation in UA/NSTEMI patients who have been treated with LMWH prior to cardiac catheterization. The choice of anticoagulant regimen at the time of intervention is based on the timing of the last subcutaneous LMWH injection, and whether a GP IIb/IIIa antagonist is used. Reference: Kereiakes DJ, Montalescot G, Antman EM, et al. Low-molecular-weight heparin therapy for non-ST-elevation acute coronary syndromes and during percutaneous coronary intervention: An expert consensus. Am Heart J. 2002:In press. 30天死亡 / 心梗绝对下降 (%) 1.7% ? 2.3% ? 用药距离发病的时间 (n=2522) (n=2041) (n=3803) (n=1105) ? 0% 0.0 0.5 1.0 1.5 2.0 2.5 3.0 6 hours 6–12 hours 12–24 hours 24 hours ? 1.7% ? 2.3% ? 2.8