药物对心脏性猝死（SCD）的预防作用.ppt

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药物对心脏性猝死（SCD）的预防作用.ppt

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TheRoleofDrugsinPreventionofSuddenCardiacDeath

WeiminLiProfessorofMedicine

CardiovascularDepartment,theFirstClinicalHospital,

HarbinMedicalUniversity，Harbin

PresentationOverview?SuddenCardiacDeathEpidemiology,etiology,pathophysiology?OverviewofICDtherapytopreventSCD?RolesofDrugsinSCDPrevention?Summaryandconclusions

EpidemiologyofSCDAccountsfor63%ofallcardiacrelateddeathsintheUS.Oneofthemostcommoncausesofdeathindevelopedcountries:MMWR.Vol51(6)Feb.15,2002.MyerbergRJ,CatellanosA.CardiacArrestandSuddenCardiacDeath.In:BraunwaldE,ed.HeartDisease:ATextbookofCardiovascularMedicine.5thEd.NewYork:WBSaunders.1997:742-779.ZhengZ.Circulation.2001;104:2158-2163.Vreede-SwagemakersJJetal.JAmCollCardiol1997;30:1500-1505.GeographyIncidenceWorldwideUS300,000~350,0003,000,000W.Europe400,000

MagnitudeofSCDinChina0.1%0.04%0.2%ChinaUS544,000300,000~350,000ChinaUSIncidenceRateAbsoluteNumber0.04%0.1%~0.2%

IncidenceofSCDinSpecificPopulationsAdaptedfrom:MyerburgRJ.SuddenCardiacDeath:ExploringtheLimitsofOurKnowledge.JCardiovascElectrophysiolVol.12,pp.369-381,March2001.300,000200,000100,000AbsolutenumberofSCDPerYearMultiplerisksubgroupsPatientswithanypreviouscoronaryeventPatientswithejection

fraction35%orCHFCardiacarrest,VT/VFsurvivorsHigh-riskpost-MIsubgroupsGeneraladultpopulation3025201050IncidenceofSCD

(%ofgroup)MADITIISCD-HeFTAVID,CASH,CIDSMADIT,MUSTT,

Suddendeathwasthefirstmanifestationofcoronaryheartdiseasein50%ofmenand63%ofwomen.CHDaccountsforatleast80%ofsuddencardiacdeathsinWesterncultures.80%

CoronaryHeartDisease15%Cardiomyopathy5%OtherDiseaseCauseofSCDAmericanHeartAssociation.HeartDiseaseandStrokeStatistics—2003Update.Dallas,Tex.:AmericanHeartAssociation;2002.Adap