课件：抗血小板药物选择策略.ppt

* * * * * * * * * The primary efficacy endpoint in CHARISMA was a cluster of the first occurrence of fatal or nonfatal MI, or fatal or nonfatal stroke (of any cause), or cardiovascular death (including haemorrhagic death) With a median of 28 months of follow-up, the primary event rate was 6.8% in the clopidogrel plus aspirin arm and 7.3% in the placebo plus aspirin arm (p=0.22, relative risk [RR] 0.93, 95% confidence interval [CI] 0.83, 1.05) (Figure 1). This reduction was not statistically significant (p=0.217) 1 The yearly primary outcome events rates were 3.12% and 3.36% for clopidogrel plus ASA vs. placebo plus ASA, respectively Clopidogrel plus ASA prevented 39 primary events overall during the study follow-up1 The Kaplan-Meier curve of the primary endpoint shows that the curves separate very early after randomization, and continue diverging over time, which indicates a continuous trend in favor of the clopidogrel and ASA treatment arm. 1 Bhatt DL, Fox KA, Hacke W, et al. 2006, in press. * To fulfill the documented coronary disease criteria, patients were required to have one of the following:1 Stable angina with documented multivessel coronary disease History of multivessel percutaneous coronary intervention (PCI) History of multivessel CABG Previous MI To fulfil the documented cerebrovascular disease criteria, patients must have had one or more of the following:1 Previous TIA within the past 5 years Previous ischemic stroke within the past 5 years To fulfil the documented symptomatic PAD criteria, patients must have had either:1 Current intermittent claudication with an ABI ≤0.85 A history of intermittent claudication together with a previous related intervention (amputation, peripheral bypass, angioplasty, etc.) Reference Bhatt DL, Topol EJ, et al. Am Heart J 2004; 148: 263–268. * Overall, 77.9% of patients had a history of documented ischemic events1 Overall, 37.4% of patients had documented CAD at baseline:1 24.7% had previous MI 11.4% had ang