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1、高筑门诊他汀防线遏制冠心病向ACS转化——再谈慢性稳定型冠心病患者他汀管理策略CURVESNASDACPediatricsStudy降脂疗效临床终点替代终点非心血管亚组分析ALLIANCEASCOT-LLAASPENAVERTCARDS4DIDEALMIRACLSPARCLTNTARMYDA-1ARMYDA-RECAPTUREGREACEPROVEITASAPBELLESESTABLISHREVERSALSAGETREADMILLVascularBasisARBITERADCLTBONESLEADe糖尿病亚组ASCOT-LLAT
2、NTPROVEIT代谢综合征亚组MIRACLTNT老年患者亚组CARDSPROVEIT阿托伐他汀里程碑研究是全球最大规模的他汀类药物临床研究：超过400项临床研究项目入选患者超过80,000名循证证据的类型梳理： 阿托伐他汀各类型均具有丰富的RCT类型RandomizedTrialofAtorvastatinforReductionofMyocardialDamageDuringCoronaryInterventionResultsFromtheARMYDA-1(AtorvastatinforReductionofMYocard
3、ialDamageduringAngioplasty)StudyVincenzoPasceri,MD,PhD;GiuseppePatti,MD;AnnunziataNusca,MD;ChristianPristipino,MD; GiuseppeRichichi,MD;GermanoDiSciascio,MD;onbehalfoftheARMYDAInvestigatorsBackground—Smallmyocardialinfarctionsafterpercutaneouscoronaryinterventionhaveb
4、eenassociatedwithhigherriskofcardiaceventsduringfollow-up.Observationalstudieshavesuggestedthatstatinsmaylowertheriskofproceduralmyocardialinjury.Theaimofourstudywastoconfirmthishypothesisinarandomizedstudy.MethodsandResults—Onehundredfifty-threepatientswithchronicst
5、ableanginawithoutpreviousstatintreatmentwereenrolledinthestudy.Patientsscheduledforelectivecoronaryinterventionwererandomizedtoatorvastatin(40mg/d,n76)orplacebo(n77)7daysbeforetheprocedure.Creatinekinase-MB,troponinI,andmyoglobinlevelsweremeasuredatbaselineandat8and2
6、4hoursaftertheprocedure.Detectionofmarkersofmyocardialinjuryabovetheuppernormallimitwassignificantlylowerinthestatingroupversustheplacebogroup:12%versus35%forcreatinekinase-MB(P0.001),20%versus48%fortroponinI(P0.0004),and22%versus51%formyoglobin(P0.0005).Myocardialin
7、farctionbycreatinekinase-MBdeterminationwasdetectedaftercoronaryinterventionin5%ofpatientsinthestatingroupandin18%ofthoseintheplacebogroup(P0.025).Postproceduralpeaklevelsofcreatinekinase-MB(2.93versus7.518ng/mL,P0.007),troponinI(0.090.2versus0.471.3ng/mL,P0.0008),an
8、dmyoglobin(5836versus8149ng/mL,P0.0002)werealsosignificantlylowerinthestatinthanintheplacebogroup.Conclusions—Pretreatmentwithatorv
