CCB在冠心病治疗领域的学术争论.pptx

CCB在冠心病治疗领域的学术争论The Academic Debates of CCB in the Fieldof CAD Treatment\ Bayer Fkaliht^irc 弋U Bayer Schering Pharma ff K % X K R隋拜新同世界最高的建筑一TOP 5哈利法塔I迪拜I62XIO命 pe 211*?M XXMUungMi World hnMKUlCfOIM SMrvjrul ?oaOptional 恥 I A J MU?\Lunipu IMvmswtfW74弋U Bayer Schering Pharmaff K % X K R隋拜新同2009, CCB在冠心病领域之争CCB究竟对心梗事件有影响吗?麻麒門心脏保护是否有如何看待CCB “新”适应证?\ Bayer Fkaliht^irc Bayer Schering Pharma隋拜新同荟萃分析：与安慰剂相比,CCB不增加心肌梗死事件(b) Myocardial infarction in CCBs vs placebo trialsEvents,Events,OR (95% Cl)CCBsNCCBs1.09 (0.93, 1.29)320/3825296/38400.72 (0.38, 1.45)14/66319/6551.25 (0.59, 2.63)16/40813/4110.93 (0.49, 1.76)19/41720/4081.07 (0.92, 1.24)369/5313348/53140.72 (0.53, 0.98)71/484199/48700.73 (0.47, 1.13)36/239847/22970.72 (0.56, 0.93)107/7239146/71670.95 (0.84, 1.09)48313063Study IDCADACTIONCAMELOT placeboNICOLEPREVENTSubtotal (l-squared = 0.0%, P = 0.650) Comparison P = 0.40HypertensionFEVERSYST-EURSubtotal (l-squared = 0.0%, P = 0.950) Comparison P = 0.01Subtotal (l-squared = 32.1%. P = 0.183)Comparison P = 0.25o〈＞0.2 0.5 1 2avours CCCBsJ Hypertens. 2009, 27:1136-1151隋拜新同Bayer Schering Pharmaff II % X K RCAMELOT:氨氯地平对非致死性心梗没有影响氨氯地平组 安慰剂组 事件数(%) 事件数(％)风险比 (95%CI)风险变化Pf￡1.14 (0.38-3.40)+14%0.822.46 (0.48-12.7)+146%0.270.73 (0.37-1.46)-27%0.37全因死亡7(1-1)6 (0.9)心血管病死亡5 (0.8)2 (0.3)非致死性心梗14(2.1)19(2.9)/Tv Baw FkalihCarc弋U Bayer Schering Pharmaff K % X K RKA珏新同C2ctk?n拜新同不增加心梗事件■一个?,CCB治疗—的大■■际仪发生率/15. OOn4.00HR=1.04 (0.88-1.24) ， P=0.62o O名患者■年安慰剂组N = 3840拜新同组N = 3825Lancet. 2004;364:849-57/Tv Baw FkalihCarcBayer Schering Pharmaff II % X K A隋拜新同如何解释拜新同“增加”冠心病事件?1.501.25-1.00-0.7S0.50-降压未带来相应获益区III冠心病的相对风险比NS GHT? ACTION■ NOSTOP-2-A4 ALLHAT-A■yALLHAT-ASCOTINVEST)VALUECONVINCE^Syst-Eur Syst-China— ■—IDNT-IrbeIDNT-pbo ,/Tv Baw FkalihCarc弋U Bayer Schering Pharmaff K % X K A陶拜新同拨乱反正正确解读冠心病获益冠心病的相对风险比4*050隋拜新同弋U Bayer Schering Pharmaff K % X K R2009, CCB在冠心病领域之争CCB究竟对心梗事件有影响吗?麻麒門心脏保护是否有如何看待CCB “新”适应证?/Tv Bayer Fkaliht^ircBayer Schering Pharma隋拜新同这样的表述正确吗？不同血管选择性CCB心脏保