降脂与重血管:一个想法,它的时间 (测试) 已经到来
1Cedars-Sinai Medical Center, Los Angeles, Calif 90048-1865, USA. forrester@csmc.edu
Circulation
|August 19, 1997
概括
重血管化不能防止心肌梗塞在稳定的冠状动脉疾病 (CAD). 降脂疗法在预防心脏病发作和改善CAD患者的存活率方面表现有前途.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 预防医学 预防医学
背景情况:
- 稳定的冠状动脉疾病 (CAD) 管理通常涉及重血管化,旨在预防心肌梗塞 (MI).
- 目前的重血管化策略针对血管学上显著的狭窄症,但证据表明,这些并不能预防心脏病发作.
- 大多数心血管感染发生在没有严重狭窄的部位,这表明当前治疗目标存在差距.
研究的目的:
- 评估重血管化的有效性与降脂疗法的有效性,以预防稳定的CAD中心肌梗塞.
- 探索冠状动脉样硬化导致心脏病发作的潜在病理.
- 确定最佳的治疗策略来管理CAD和预防MI.
主要方法:
- 对稳定的冠状动脉病患者的复血管化 (冠状动脉旁路移植手术,皮肤透光冠状动脉血管塑造) 证据的审查.
- 对血管和研究数据关于病变严重程度和缺血的分析.
- 复血管化和降脂疗法对心脏病发作率的影响的比较.
主要成果:
- 在稳定的CAD患者中,重血管化不能预防心肌梗塞.
- 心肌梗塞经常发生在非狭窄或轻微狭窄的部位.
- 降脂疗法在5年内将心肌梗塞发生率降低约30%.
结论:
- 重血管治疗不能解决导致心肌梗塞的病变.
- 降脂疗法在预防心脏病发作和改善CAD的长期存活率方面似乎比重血管化更有效.
- 需要进一步的研究来确定降脂和重血管化的作用在CAD管理中.
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