非ST段抬高急性冠脉综合征.pptx

Non-ST Elevation Acute Coronary Syndromes
Million Hospital
Discharges
AHA. Heart Disease and Stroke
Statistics—2005 Update
ACS
STEMI
Hospital Discharges for ACS Non-STE ACS vs STEMI
NSTE ACS
Million
Discharges/Yr
321,000
Discharge/Yr
NSTE ACS : Key Themes
NSTE ACS: a high risk population
 patient risk   benefit from treatment with medications, an invasive strategy
Interaction between invasive strategy and pharmacologic tx
Antithrombotics cornerstone of treatment
Anticoagulants: heparin, LMWH, direct thrombin inhibitors
Antiplatelet agents: aspirin, IIb/IIIa, ADP inhibitors
Baseline Characteristics NSTE ACS Patients:Recent RCTs and Large Registry
Q2 2003
PURSUIT CURE GUSTO-IV ACS CRUSADE Characteristic (n = 9,461) (n = 12,562) (n = 7,800) (n = 5,426)
Mean age ± SD (yrs) 63 ± 11 63 ± 12 65 ± 11 67 ± 14
Diabetes mellitus (%) 23 23 22 33
Prior CHF (%) 11 8 8 19
Prior PCI (%) 13 --- 10 22
Prior CABG (%) 12 18* 8 20
NEJM 1998;339:436; NEJM 2001;345:494 ; Lancet 2001;357:1915-24
* CABG or PTCA
Antman EM et al N Engl J Med 1996;335:1342-9
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