调脂治疗常见问题解答与建议.ppt

感谢大家观看第63页,共63页，星期六，2024年，5月**Fromthisslideyoucanobservethatare-lationshipbetweenserumcholesterollevelandcoronaryheartdiseaseriskhasbeenestab-lishedandthishasbeenverifiedalsoinseveralepidemiologicalstudies,notablythePoolingProject,FraminghamHeartStudyandtheIsraeliProspectiveStudy.**IncidenceofMIduringa7-yearfollow-upinaFinnishpopulationInapopulation-basedstudyconductedineasternandwesternFinland,morethan1,000diabeticsubjectsandalmost1,400nondiabeticsubjectswerefollowedupfor7years.SubjectswerestratifiedbybaselinestatusforbothpriorMIanddiabetes.SubjectswhohadbothapriorMIanddiabeteshadahigherriskofafutureMI.SubjectswithdiabetesbutwithoutapriorMIhadasimilarriskoffutureMIasnondiabeticsubjectswithapriorMI.ThisstudythussupportstheconceptofdiabetesasaCHDriskequivalent.Reference:HaffnerSM,LehtoS,RonnemaaT,PyoralaK,LaaksoM.Mortalityfromcoronaryheartdiseaseinsubjectswithtype2diabetesandinnondiabeticsubjectswithandwithoutpriormyocardialinfarction.NEnglJMed1998;339:229-234.**CARE研究的主要终点冠心病死亡率和非致死性心梗危险下降了24%(P=0.003)。此外，在普拉固治疗组非致死性心梗危险下降了23%(P=0.02)，CABG危险下级26%(P=0.005)，PTCA下降23%(P=0.01)。普拉固(P0.05)治疗组显著降低卒中危险达31%。**LIPID研究的主要终点冠心病死亡率下降了24%。此外，总死亡率下降了23%，致死性冠心病及非致死性心梗危险下降了24%（P=0.02），普拉固治疗组显著降低卒中危险达18%。**IntheHPS,thesignificantlyreducedrelativeriskoftotalstrokewithsimvastatin40mgperday(RR=25%,p0.0001)wassimilartothe24%RRforanymajorvascularevent(p0.0001).4Strokeoccurredin444of10,269patients(4.3%)inthesimvastatingroup,comparedwith585of10,267patients(5.7%)intheplacebogroup.Respectivenumbersofpatientswithincidentsofischemicstrokewere290(2.8%)amongrecipientsofsimvastatinand409(4.0%)amongthosereceivingplacebo.4Incidenceofhemorrhagicstrokewas0.5%inbothpatientgroupsreceivingplacebo(53/10,