冠心病的发生发展ppt课件.ppt

* Thank you ! * * * This chart shows that patients with a history of ischemic events have an increased risk of a second vascular event. In patients with a previous IS, the risk of MI is up to 3 times greater and the risk of stroke up to 9 times greater compared with the general population. For patients with a previous MI, a recurrent MI is 5–7 times more likely and the risk of stroke is 3–4-fold more likely than in the general population. Increased risk of a further MI with previous PAD is 4 times greater and 2–3 times more likely to result in stroke. The increase in risk of events was based on a 10-year follow-up except for risk of stroke following stroke, which measures subsequent risk per year.1–4 The increased risk of recurrent events shows the clear need for a global treatment strategy for preventing both cardiovascular and cerebrovascular events. References 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. * * 该图示了从仅有高危因素的血管发展为动脉粥样硬化，最后形成动脉粥样硬化血栓形成的过程。动脉粥样硬化血栓形成所造成的疾病事件通常是致命性的，包括不稳定心绞痛，心肌梗死，缺血性脑卒中，短暂性脑缺血发作，严重下肢缺血，间歇性跛行和心血管死亡。 * Atherosclerosis is an ongoing process affecting mainly large-sized and medium-sized arteries; it can begin in childhood and progress throughout a person’s lifetime. Stable atherosclerotic plaques may encroach on the lumen of the artery and cause chronic ischemia, resulting in (stable) angina pectoris or intermittent claudication, depending on the vascular bed affected. Unstable atherosclerotic plaques may rupture, leading to the formation of a platelet-rich thrombus that partially or completely occludes the artery and causes acute ischemic symptoms. Reference: Rauch U, Osende JI, Fuster V, et al. Thrombus formation on atherosclerotic plaques: pathogenesis and critical consequences. Ann Intern Med. 2001;134:224-238. Stary HC, Chandler AB, Dins