慢性稳定性心绞痛的治疗（英文）

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1、GUIDELINESFORTHEMANAGEMENTOFCHRONICSTABLEANGINAAmericanCollegeofCardiology,PuertoRicoChapter,February6,2007GAPTheGoalsofTherapyinCADToimprovequalityoflife(symptoms)ToreducemortalityToreducemorbidityToreduceprogressionofdiseaseandinduceregression.TreatmentofChronicStableAnginaMedicalRevascul

2、arizationPCIACBGMEDICALTHERAPYANTIPLATELETSBETABLOCKERSNITRATESCALCIUMANTAGONISTACEISTATINSNEWTHERAPIESANTIPLATELETAGENTSASAPhysicians’HealthStudySwedishAnginaPectorisTrialTICLOPIDINECLOPIDOGRELCAPRICUREReceptorGPIIb-IIIa:TheFinalCommonPathwaytoPlateletAggregationWhiteHD.AmJCardiol1997;80:2

3、B-10B.SchaferA.JClinInvest1986;78:73-79.DeJongMJ,etal.CriticalCareNursingClinofNAm1999;11:355-371.MoserM,etal.JCardiovascPharmacol2003;41:586-592.PhillipsDR,ScarboroughRM.AmJCardiol1997;80(4A):11B-20B.GPIIb-IIIainhibitorsdisplacefibrinogeninexistingthrombitodisaggregatethrombusandpreventfur

4、therplateletcross-linkingandthrombosisGPIIb-IIIainhibitorspreventplateletactivationbyblockingGPIIb-IIa(outside-insignaling)High-doseheparinstimulatesPAFwhichactivatesplateletsPHYSICIANS'HEALTHSTUDYArandomized,double-blind,placebocontrolledtrialdesignedtotesttheeffectsoflow-doseaspirinandbet

5、a-caroteneintheprimarypreventionofCVDandcanceramong22,071USmalephysicians,aged40to84atbaselinein1982.Baselinebloodspecimenswerecollectedandfrozenforlateranalysesfrom14,916participants.Usinga2x2factorialdesign:325mgofaspirin(Bufferin,suppliedbyBristol-MyersProductsonalternatedays)50mgofbeta

6、-carotene(Lurotin,suppliedbyBASFAGonalternatedays)PHYSICIANS'HEALTHSTUDY•Totalcancer•Prostatecancer•Cardiovasculardisease•EyediseaseäCataractäMaculardegenerationPrimaryEndpointsPHYSICIANS'HEALTHSTUDYThetrial'sDataandSafetyMonitoringBoardstoppedtheaspirinarmofthePHSseveralyearsaheadofschedu

7、lebecauseitwasclearthataspirinhadasignificanteffectontheriskofafirstmyocardialinfarction.AsreportedintheJuly20,1989NewEnglandJournalofMedicine,aspirinreducedtheriskoffirstmyocardialinfarctionby44%(Plessthan0.00001).Thereweretoofewstrokesordeathsuponwhich