脂代谢与动 脉粥样硬化.ppt 37页

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    VYT 2007-W-187237-SS Mean baseline LDL-C was 150.2 mg/dL (3.89 mmol/L) in both the pravastatin and atorvastatin treatment groups. Patients receiving intensive therapy with atorvastatin 80 mg achieved a mean LDL-C value of 78.9 mg/dL (2.04 mmol/L), representing a reduction of 46% from baseline. Patients receiving moderate lipid-lowering therapy with pravastatin 40 mg achieved a mean LDL-C value of 110.4 mg/dL (2.86 mmol/L), representing a reduction of 25% from baseline (P<0.001 vs atorvastatin).1 The difference in LDL-C lowering between groups was paralleled by a difference in the progression of atherosclerosis. The group receiving intensive LDL-C–lowering therapy showed a net decrease of 0.4% in atheroma volume, demonstrating no progression of atherosclerosis, whereas a 2.7% increase was observed in the moderate LDL-C–lowering therapy group (P=0.02 between groups).1 These results from the Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) trial suggest that an LDL-C reduction of 50% or more may be required to reduce the progression of coronary atherosclerosis in the patients studied.1 Reference Nissen SE, Tuzcu EM, Schoenhagen P, et al for the REVERSAL Investigators. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA. 2004;291:1071–1080. Source: EZT 2005-W-166238-SS VYT 2007-W-187237-SS Recent guidelines (2003) from the Third Joint Task Force of The European Society and Other Societies on Cardiovascular Disease Prevention recommend that patients with clinically established CVD and patients with diabetes should maintain total cholesterol levels <175 mg/dL (<4.5?mmol/L) and LDL-C levels <100?mg/dL (<2.5 mmol/L). The guidelines specifically recommend lower target levels in patients with CVD and diabetes; in the general population, recommended levels are <115?mg/dL (<3?mmol/L) for LDL-C and <190?mg/dL (<5 mmol/L) for total cholesterol.1 These guidelines

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