药物对心脏性猝死SCD的预防作用.pptx

会计学1 Presentation Overview? Sudden Cardiac Death Epidemiology, etiology, pathophysiology? Overview of ICD therapy to prevent SCD ? Roles of Drugs in SCD Prevention ? Summary and conclusions第1页/共53页 Epidemiology of SCD Accounts for 63% of all cardiac related deaths in the US. One of the most common causes of death in developed countries: MMWR. Vol 51(6) Feb. 15, 2002. Myerberg RJ, Catellanos A. Cardiac Arrest and Sudden Cardiac Death. In: Braunwald E, ed. Heart Disease: A Textbook of Cardiovascular Medicine. 5th Ed. New York: WB Saunders. 1997: 742-779. Zheng Z. Circulation. 2001;104:2158-2163. Vreede-Swagemakers JJ et al. J Am Coll Cardiol 1997; 30: 1500-1505.GeographyIncidenceWorldwideUS300,000~350,0003,000,000W.Europe400,000第2页/共53页 Magnitude of SCD in China0.1%0.04%0.2%ChinaUS544,000300,000~350,000ChinaUSIncidence RateAbsolute Number0.04%0.1%~0.2%第3页/共53页 Incidence of SCD in Specific Populations Adapted from: Myerburg RJ. Sudden Cardiac Death: Exploring the Limits of Our Knowledge. J Cardiovasc Electrophysiol Vol. 12, pp. 369-381, March 2001. 300,000200,000100,000Absolute number of SCD Per Year Multiple risk subgroupsPatients with any previous coronary eventPatients with ejectionfraction 35% or CHFCardiac arrest, VT/VF survivorsHigh-risk post-MI subgroupsGeneral adult population3025201050Incidence of SCD(% of group) MADIT II SCD-HeFT AVID, CASH, CIDS MADIT, MUSTT, 第4页/共53页 Sudden death was the first manifestation of coronary heart disease in 50% of men and 63% of women. CHD accounts for at least 80% of sudden cardiac deaths in Western cultures.80%Coronary Heart Disease15% Cardiomyopathy5% Other Disease Cause of SCDAmerican Heart Association. Heart Disease and Stroke Statistics—2003 Update. Dallas, Tex.: American Heart Association; 2002. Adapted from Heikki et al. N Engl J Med, Vol. 345, No. 20, 2001.Myerberg RJ. Heart Disease, A Textbook of Cardiovascular Medicine. 6th ed. P. 895.第5页/共53页 Arrhyth