急性冠脉综合征早期他汀类药物治疗的目的和机制

被引:6
作者
施仲伟
机构
[1] 上海第二医科大学瑞金医院心脏科上海
关键词
急性冠脉综合征; 急性冠脉综合症; 他汀类; 药物治疗;
D O I
暂无
中图分类号
R541.4 [冠状动脉(粥样)硬化性心脏病(冠心病)];
学科分类号
1002 ; 100201 ;
摘要
<正> 急性冠脉综合征早期采用他汀类药物治疗是最近两年中的热门研究课题之一,本文讨论这一治疗方案的目的和机制。1.为什么这一课题最近才提上议事日程 在冠心病二级预防中,他汀类药物的长期使用能够显著降低冠心病死亡率、中风发生率和总死亡率。然而过去的临床试验,仅选择病情稳定的患者进行研究。例如4S、CARE和LIPID三项试验的观察对象,都是在急性心肌梗死(AMI)或不稳定心绞痛等急性事件发生3~6个月以后才开始接受他汀类药物治疗。这是因为当时人们认为,调脂药物只能通过调整血脂水平发挥作用,起效较慢;因此对于急性冠脉综合征(AMI或不稳定心绞痛)早期由于室性心律失常、心力衰竭或不稳定斑块破裂所引起的冠心病死亡或心肌梗死,他汀类药物不可能产生有
引用
收藏
页码:125 / 126+128 +128
页数:3
相关论文
共 8 条
[1]  
Improved treatment of coronary heart disease by implementation of a Cardiac Hospitalization Atherosclerosis Management Program (CHAMP)[J] . Gregg C Fonarow,Anna Gawlinski,Samira Moughrabi,Jan H Tillisch.The American Journal of Cardiology . 2001 (7)
[2]  
What is the role of intensive cholesterol lowering in the treatment of acute coronary syndromes?[J] . David D Waters,Priscilla Y Hsue.The American Journal of Cardiology . 2001 (7)
[3]  
Rationale and design of the cardiac hospitalization atherosclerosis management program at the University of California Los Angeles[J] . Gregg C Fonarow,Anna Gawlinski.The American Journal of Cardiology . 2000 (3)
[4]  
Cholesterol Lowering: Should It Continue to Be the Last Thing We Do?[J] . David Waters.Circulation . 1999 (25)
[5]  
Cholesterol Reduction Rapidly Improves Endothelial Function After Acute Coronary Syndromes: The RECIFE (Reduction of Cholesterol in Ischemia and Function of the Endothelium) Trial[J] . Jocelyn Dupuis,Jean-Claude Tardif,Peter Cernacek,Pierre Theroux.Circulation . 1999 (25)
[6]  
Simvastatin, an HMG-Coenzyme A Reductase Inhibitor, Improves Endothelial Function Within 1 Month[J] . Gerard O’Driscoll,Danny Green,Roger R. Taylor.Circulation . 1997 (5)
[7]  
Hyperlipidemia and Coronary Disease: Correction of the Increased Thrombogenic Potential With Cholesterol Reduction[J] . Lucie Lacoste,Jules Y.T. Lam,Joseph Hung,Glaci Letchacovski,Charles B. Solymoss,David Waters.Circulation . 1995 (11)
[8]  
Atherosclerosis/Coronary Heart Disease: Short-term Cholesterol Lowering Decreases Size and Severity of Perfusion Abnormalities by Positron Emission Tomography After Dipyridamole in Patients With Coronary Artery Disease: A Potential Noninvasive Marker of Healing Coronary Endothelium[J] . K. Lance Gould,James P. Martucci,Dennis I. Goldberg,Mary Jane Hess,R. Patterson Edens,Rifat Latifi,Stanley J. Dudrick.Circulation . 1994 (4)