Tue 1 May, 2012 02:36 am
Columbia University in New York BenjiaminZGalper Dr., for CPR all coronary patients, regardless of their low density (LDL) cholesterol levels, use of large doses of statins than other known coronary risk stratification, treatment strategies and more economical and effective.2012 American College of Cardiology (ACC) annual meeting, Gapler show its age in the 35-80 year-old men and women 45-80 years old, five kinds of identification and treatment of CPS1 coronary artery disease risk factors strategy analysis results. 5 kinds of methods:(1) "treatment for all". Everyone, regardless of their Framingham risk score or LDL baseline levels, can be used high doses of statins and low-dose aspirin.(2) based on National Cholesterol Education Program Adult Treatment Panel (ATP) III recommended statin dose, with CR2 the Framingham score and LDL levels.(3)-based heart disease prevention and eliminate Association (SocietyforHeartAttackandPreventionandEradication SHAPE) published a guide, the guide to determine the risk factors of coronary artery calcification (CAC) and CT scan results.(4) In Texas, improved by the regulations set SHAPE method, based on the Farmingham score and CAC scanning patients further stratified the risk of CRABP1 coronary artery disease> 10% D patients.(5) Based on the revised results of statin use for primary prevention of a strategy: the one Ruishu cutting his small intervention clinical studies have evaluated (the JUPITER). LDL is higher than 130mg/dl and C-reactive protein (CRP) High 2mg / L in patients taking 40mg of Ruishu cutting statins.
Galper, etc. for 30 years based on the detection of the cost of statins, as well as the expected number of patients were classified as moderate or high risk by the screening strategy and Markov-chainMonteCarlo statistical analysis. The study also considered the risk of cancer caused by radioactive imaging, but consider that statins increase the risk of diabetes, Galper said, because "it is not clear correlation between clinical" In CRABP2 addition to the "cure all" The outside of each treatment strategy, the Framingham risk greater than 10% of patients were assumed to be taking low-dose aspirin.Galper talked about "Our simulation results show that the Alto for all men and women using high doses of atorvastatin, and all men using low-dose aspirin is an effective method of primary prevention of coronary artery disease. Comparison of 2011 actual data of statin treatment and coronary artery disease, all analysis methods and existing methods are more effective than more economical. Become the most effective strategy for the treatment of men and women, all treatment methods, respectively, compared with existing strategies to increase the 187 860 and 68 350 quality-adjusted life years (QALYs). In men, the treatment of all strategies to prevent 160 000 myocardial infarction (MIs,). The other end of the list, according to the statistical model, the Texas method in the male only can prevent 75,000 cases of MIs, For men, the cure for all all the methods, the cheapest and most cost-effective method.Method of prevention for women, the JUPITER Guide MIs range of 5848, all treatment methods to prevent MIs occurred in the range of 394 000. In women, the SHAPE method is the cheapest, but with the SHAPE method, the application of the method of treatment for all, the cost is only 2425 dollars per QALYs, therefore, it is also very economical.MIs, the SHPAE strategy than ATPIII method can better prevention, but can cause about 206 cases of radiation-associated malignancies, statin treatment based on the ATPIII the method the number of patients at least (28%).
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