pci围手术期调脂治疗

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1、他汀类的作用TheBenefitofStatinTherapyBeforeandAfterCoronaryRevascularization首都医科大学附属北京安贞医院北京市心肺血管疾病研究所颜红兵Meta-AnalysisoftheRoleofStatinTherapyinReducingMIFollowingElectivePCI•Moodetal.selectedstudiesthatrandomizedptswhounderwentelectivePCItostatintherapyversusplacebo/usualcare.•Tobeincluded,statin

2、therapywasrequiredtobeinitiatedaroundthetimeofPCI,andindividualoutcomedatawererequiredtobecollected.•TheprimaryendpointwasMI.•Thesecondaryendpointswereall-causemortality,CVmortality,CABGorPCI,andstroke.Moodetal.AmJCardiol.2007Sep15;100(6):919-23StudiesIncludedinMeta-Analysis•6studiesweresele

3、cted:PREDICT-PreventionofRestenosisbyElisorAfterTransluminalCoronaryAngioplastyFLARE-FluvastatinAngioplastyRestenosisGAIN-GermanAtorvastatinIntravascularUltrasoundLIPS-LescolInterventionPreventionStudyARMYDA-AtorvastatinforReductionofMIDuringAngioplastyBriguorietal-Randomized3,941pts(1

4、,967tostatinsand1,974toplacebos)Moodetal.AmJCardiol.2007Sep15;100(6):919-23CholesterolDataofStudyParticipants(StatinArm/PlaceboArm)VariablePREDICTFLAREGAINLIPSARMYDABriguorietalBaselineTotalcholesterol228/231222/223228/242200/199--197/196(mg/dl)LDLcholesterol155/157153/153155/166131/132--121

5、/122(mg/dl)Follow-upTotalcholesterol195/239--156/215----168/193*(mg/dl)LDLcholesterol119/159102/14986/14095/147--93/121*(mg/dl)*LevelatindexprocedureLDL=low-densitylipoproteinMoodetal.AmJCardiol.2007Sep15;100(6):919-23OddsofMIafterPCIOddsRatio95%CIPREDICTFLAREGAINLIPSARMYDABriguoriOverallOR=

6、0.57(0.42-0.78)Moodetal.AmJCardiol.2007Sep15;100(6):919-23CumulativeCVMortalityResults•ThecumulativeincidenceofCVmortalityinptsamongthestatingroupvsplacebogroupwas0.71%vs1.2%,respectively(OR0.58,95%CI0.30to1.11,p=0.10).•Theweightedmeandurationoffollow-upwas20.6months,andtheabsolutedifference

7、betweenthegroupswas0.8%(p=0.10).Moodetal.AmJCardiol.2007Sep15;100(6):919-23CumulativeRepeatSurgicalorPCI•Amongtheptsrandomizedtostatintherapyversusplacebo,thecumulativeincidenceofrepeatCABGorPCIwas19.6%vs21.9%,respectively(OR0.89,95%CI0.78to1.02,p=