医学交流课件：冠心病.pptVIP

TherapeuticsAcute Coronary Syndromes-Post discharge A: Antiplatelets / ACE-I B: β- blockers / Bp control C: Cholesterol lowering (Statins) / Cigarette quitting D: Diabetes control / Diet E: Exercise / Education LDL-C↓ VLDL↓, IDL↓, LDL-C↓ Endothelium function SMC function Anti-inflammation Thrombosis↓ lumen Lipid core Macrophages SMC Potential clinical benefits of Statins in ACS Statins Take Home Messages Atherosclerosis is the leading cause of death and disability, also the main cause of CHD Risk factors and prevention of atherosclerosis CHD is due to the imbalance between myocardial oxygen supply and demand Two large groups of CHD: chronic(stable angina pectoris) and ACS ACS composed of UAP/NSTEMI and STEMI, resulting from the plaque rupture or erosion, with differing degree of thrombosis and distal embolization, with different obstruction of the coronary artery. reperfusion either by fibrinolysis or primary PCI is the mainstay of therapy of STEMI Thanks! The catheter is passed through the sheath, over the guidewire, retrograde (against blood flow) to the aorta and the aortic valve and origins of the left and right coronary system. Dye is injected into the vessel for visualization of the left and right coronary arteries and left ventricle. 可以从3方面举例说明他汀药物降低冠心病风险的益处。降低低密度脂蛋白(LDL-C) 是他汀药物必不可少的作用。然而，在WOSCOPS研究中对普伐他汀降脂作用的分析显示普伐他汀所得的临床益处并不能仅由血脂水平变化来解释。 他汀药物可能除了可改变LDL-C以外，还对一项或多项血脂指标的水平有影响，可能包括乳糜微粒， 小核LDL-C，极低密度脂蛋白（VLDL）残粒或中间密度脂蛋白 (IDL) 。使这些脂质微粒水平下降的作用可能解释普伐他汀治疗患者中预期事件发生率与实际发生率之间的差异。 而且，还可观察到普伐他汀的非降脂作用，例如恢复内皮功能，稳定斑块，抗炎或减少血栓形成等。目前正积极探讨和研究以上这些及其它方面的额外作用机制。 Welcome Agenda: 1) Definition of optimal post-dilatation (i.e. the most effective practice) 2) Why is optimal post-dilatation important? 3) POSTIT Trial 4) Semi-Compliant vs. Low or NC 5) DES and Post Dilatation (Simple vs. Complex Lesions) 6) SATs, In-Stent Restenosis 7) Conclusions  Procedure of PTCA Stent Coronary Artery Bypass Graft --CABG Acute Coronary Syndromes ST segment