β受体阻滞剂在PCI中的应用.pptx

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1、β受体阻滞剂在PCI术的应用CV-1211-BE-0451有效期至2013年12月心率增快增加冠心病患者的风险！Theeffectofheartrateonlocalhaemodynamicforcesontheendothelium.Mechanismswherebyanelevatedheartrateleadstoadverseoutcomesinpatientswithcoronaryarterydisease.ImpactofLeftVentricularEjectionFractiononClinicalOutcomesOver

2、FiveYearsAfterInfarct-RelatedCoronaryArteryRecanalization(fromtheOccludedArteryTrial[OAT])Inconclusion,optimalmedicaltherapyremainstheoveralltreatmentofchoiceforstablepatientswithapersistenttotalocclusionoftheinfarct-relatedarteryafteracutemyocardialinfarction,irrespective

3、ofthebaselineEF.Inpatientswithnormalormoderatelyimpairedleftventricularcontractility,PCIreducedtheneedforsubsequentrevascularizationbutdidnototherwiseimproveoutcomes.(AmJCardiol2010;105:10–16)包括美托洛尔在内的最佳药物治疗仍然是冠心病治疗的基石！β阻滞剂在急性心肌梗死的应用Setting/indicationClassLeveli.v.administ

4、rationForreliefofischaemicpainTocontrolhypertension,sinustachycardiaPrimarypreventionofsuddencardiacdeathSustainedventriculartachycardiaSupraventriculartachyarrhythmiasTolimitinfarctsizeAllpatientswithoutcontraindicationsOraladministrationAllpatientswithoutcontraindication

5、sIIIIIIIaIIbIBBBCCAAAβ阻滞剂在慢性稳定性心绞痛的应用Expertconsensusdocumentonβ-adrenergicreceptorblockers.EuropeanHeartJournal.2004,25:1341–1362.Setting/indicationClassLevelPreviousinfarctionToimprovesurvivalToreducereinfarctionToprevent/controlischaemiaNopreviousinfarctionToimprovesurvi

6、valToreducereinfarctionToprevent/controlischaemiaIIIIIIAAACBAβ阻滞剂在非ST段抬高ACS的应用Setting/indicationClassLevelEarlybenefit,reductionofischaemiaEarlybenefit,preventionMILong-termsecondarypreventionIIIBBB实践与指南的差距：β阻滞剂在中国冠心病患者中使用现状中华医学会心血管病学分会中华心血管病杂志编辑委员会.β肾上腺素能受体阻滞剂在心血管疾病应用专家共识.使

7、用率低使用时间滞后剂量较低获益渐少β受体阻滞剂在PCI围手术期的应用但是在PCI围手术期间的使用？2009FocusedUpdates:ACC/AHAGuidelinesfortheManagementofPatientsWithST-ElevationMyocardialInfarction.2007FocusedUpdateoftheACC/AHA/SCAI2005GuidelineUpdateforPercutaneousCoronaryIntervention..Antithrombotic：1.UH,LMWH2.GPIIb/III

8、aInhibitors3.Bivalirudinβ-block？statin？Antiplatelet：1.Aspirin2.clopidogrelβ受体阻断剂在PCI围手术期间