抗血小板与动脉粥样硬化血栓形成的防治 ppt课件.ppt

需要进行更加有效的二级预防！ * * Atherothrombosis is the underlying condition that results in events leading to myocardial infarction, ischemic stroke and vascular death. As such, the leading cause of death of the estimated 55 694 000 people worldwide who died in 2000 was atherothrombosis, manifested mainly as cardiovascular/cerebrovascular death. Other major causes of death were: AIDS (5.1%) Pulmonary disease (6%) Injuries (9.1%) Cancer (12.6%) Infectious and parasitic diseases (17.8%).1 Reference 1. The World Health Report 2002, WHO Geneva * 本图显示，有缺血性事件史的病人再发血管事件的风险升高。 在有IS史的病人，MI的风险比普通人群升高了3倍，中风的风险升高了9倍。在有MI史的病人，MI复发的可能性是普通人群的5-7倍，中风的风险是3-4倍。在有PAD史的病人，再发MI的风险升高了4倍，中风的风险升高了2-3倍。 事件发生风险的升高是根据10年随访的结果，中风后再中风的风险除外，用每年的风险增加来衡量。1–4 事件复发风险的升高明显提示，需要在全球实施预防心脑血管事件的治疗策略。 参考文献 Kannel WB. J Cardiovasc Risk 1994; 1: 333–339. Wilterdink JI, Easton JD. Arch Neurol 1992; 49: 857– 863. Adult Treatment Panel II. Circulation 1994; 89: 1333–1363. Criqui MH, et al. N Engl J Med 1992; 326: 381–386. * Many patients with UA/NSTEMI have chronic stable angina at hospital discharge. The management of the patient with stable CAD is detailed in the ACC/AHA/ACP-ASIM Guidelines for the Management of Patients With Chronic Stable Angina)1. The following are recommendations (Class I) for pharmacotherapy to prevent death and myocardial infarction: ASA 75 to 325 mg per d in the absence of contraindications (level of evidence: A) clopidogrel 75 mg daily (in the absence of contraindications), when ASA is not tolerated because of hypersensitivity or gastrointestinal intolerance. (level of evidence: AB) the combination of ASA and clopidogrel for 9 months after UA/NSTEMI. (level of evidence: B) Beta-blockers in the absence of contraindications (level of evidence: B) Lipid-lowering agents and diet in post-ACS patients, including postrevascularization patients, with lowdensity lipoprotein (LDL) cholesterol of greater than 130 mg per dL (level of evidence : A) Lipid-lowering agents if LDL cholesterol level after diet