2007PCI热点话题-英文课件精选.pptVIP

Adverse Events (Death Q-wave MI)RAVEL, SIRIUS, E-SIRIUS, C-SIRIUS ARC Proposed Standard Definitions Definite/Confirmed Acute coronary syndrome AND [Angiographic confirmation of thrombus or occlusion OR Pathologic confirmation of acute thrombosis] Probable Unexplained death within 30 days Target vessel MI without angiographic confirmation of thrombosis or other identified culprit lesion Possible Unexplained death after 30 days Stent Thrombosis: FDA Advisory Panel, 8RCT DES vs. BMS RegistriesMortality Drug-Eluting and Bare Metal Stenting in Massachusetts Matched Risk Differences at 2 years Baseline Characteristics 1 Baseline Characteristics 2 Procedural Characteristics Proportion of DES per Lesion Freedom from Death (All Patients) Freedom from Death (Excluding AMI) Freedom from MI (All Patients) Freedom from Death or MI (All Patients) Freedom from Definite Thrombosis Freedom from Definite/Probable Thrombosis Freedom from Definite/Probable/Possible Thrombosis Freedom from TLR (All Patients) Freedom from TVR (All Patients) Taxus Pathology at 6-Months Discontinuation of Anti-platelet Therapy and Risk for ST Summary Long-term efficacy of DES is persistent and the safety of DES is confirmed by meta-analysis based on patients level Late stent thrombosis after DES implantation has emerged as a concerning entity Indication for DES stenting Proper dual antiplatelet therapy, at least 1year Technical improvement of DES and new type of DES are emerging and promising 关于PCI某些适应证的思考 COURAGE: Study design COURAGE: Treatment effects COURAGE: Treatment effect on hospitalization for ACS COURAGE: Treatment effect on angina Treatment effect in CV and diabetes subgroups Need for Subsequent Revascularization At a median 4.6 year follow-up, 21.1% of the PCI patients required an additional revascularization, compared to 32.6% of the OMT group who required a 1st revascularization 77 patients in the PCI group and 81 patients in the OMT group required subsequent CABG surgery Medi