医学优质课件精选——《现代脂质三联治疗》
46页1、,现代脂质三联治疗,执教教师:XXX,Introduction,Part I,Efficacy - The Power to Reach Target,Key Factor: + Differentiators: LDL Reduction TG HDL LDL/HDL Ratio The Lipid Triad,The LDL/HDL Ratio - Our Strength, Our Story!,A new perception of efficacy,LDL,HDL,Additional risk factor, especially in diabetics,The Lipid Triad - Overview,TG,The Lipid Triad,The Ratio,The Lipid Triad and Strategic Rationale,Part II,No scientific evidence Evidence contradicting this statement A marketing hypothesis to build their LDL story
2、 Creating the perception of the statin with the strongest efficacy,The lower. .the better?,Its logical,Its measurable,Its practicable,The Lipid Triad - The GPs Perspective,HDL,LDL,Supporting Data from Landmark Studies,Part III,12 10 8 6 4 2 0,% Mortality,Placebo Q1 Q2 Q3 Q4 (low HDL-increase) (high HDL-increase),4S - Study,CAD Mortality per Quartiles of Increases in HDL-Cholesterol,KJEKSHUS J & PEDERSEN T (unpublished),HDL Intervention Trial (VA-HIT),RUBINS HB et al. New Engl J Med 1999; 341:410
3、,0,6,-31,-4,-35,-30,-25,-20,-15,-10,-5,0,5,10,Cholesterol LDL-C HDL-C Triglycerides,Percent change compared to placebo at 1 year,Secondary Prevention in 2531 men with low HDL-C & LDL-C showed a 22% reduction in combined fatal and non-fatal MI,HDL - Cholesterol as Risk Factor for CHD,LRC - CPPT (Placebo),MRFIT (usual care),Incidence rate of CHD,Incidence rate of CHD,12 10 8 6 4 2 0,100 130 160 190,GORDON DJ et al. Circulation 1989; 79: 8 - 15.,HDL - C mg / dl 65 55 45 35,LDL - Cholesterol mg / dl
4、,LDL - Cholesterol mg / dl,12 10 8 6 4 2 0,100 130 160 190,0,0.5,1,1.5,2,2.5,3,Framingham Heart Study,CAD risk as a function of LDL-C and HDL-C in men (50 to 70 y),CASTELLI WP. Am J Cardiol 1998; 82:60-65,220 160 100,85,65,45,25,HDL-Cholesterol (mg/dl),LDL Cholesterol (mg/dL),0,2,4,6,8,10,12,14,16,LDL=5,LDL5,HDL=1.08,HDL1.08,LDL/HDL=5,LDL/HDL5,Incidence of cardiac events,(per 1000 person-years),Gemfibrozil,Placebo,LDL-C Tertiles (mmol/L),HDL-C Tertiles (mmol/L),LDL-C/HDL-C Tertiles,Incidence for
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