Вы находитесь на странице: 1из 30

[]

... ..


-
2012

[]


ISIS 1 (n=16 027)
<12 ( 5)

- 15%

(95% 1-27%)
=0,04

5-10
10 50
12 50
100
1-2 7

Lancet 1986; July 12: 5765


Goteborg (n=1 395)
<48

15
15 200 /

Lancet 1981; October 17: 8237


MIAMI (n=5 778)
<24
(%)

15
15 200 /

* 3 :
>60, ,
, ,
, , ,
/

Eur Heart J 1985; October 17 6: 199226


TIMI IIb (n=1 434)
/ 18-48

6
( 2 /:
50
,
100 )

(/ 15
2 /: 50
,
100 )

3,5%

3,6%

5,1%

2,7%

0,02

24,1%

18,8%

<0,02

Circulation 1991; 83: 42237

- ST
COMMIT/CCS2 (, n=45 852)
<24 ( ST 93%)
, 54% 106
( Killip II-III), <100, <50, - II-III .

(/ 15 15 50 4 3-
200 1 4 ) vs
2

1000

-5

-5

Lancet 2005; 366: 1622-32

1000
*

+ 11

- ST
COMMIT/CCS2 (, n=45 852)

0-1
2
3

0,4

0,7

1,0

1,3

1,6

1,9

Lancet 2005; 366: 1622-32

- ST
COMMIT/CCS2 (, n=45 852)

0-1

0,4

0,7

1,0

1,3

1,6

1,9

0,4

0,7

1,0

1,3

1,6

* : 70, <120, >110, Killip III


Lancet 2005; 366: 1622-32

/ -
:
c COMMIT-CCS 2

( ) -


-
2


/
-

-
- (n=52 411)
26 + MIAMI () + ISIS-1 () +
COMMIT/CCS2 (, : >105, >65, Killip I)


-

1000

- 13%

-7

0,0006

- 22%

-5

0,0002

- 15%

-5

0,002

Lancet 2005; 366: 1622-32

-
(2012)



- ,


Eur Heart J 2012; doi:10.1093/eurheartj/ehs215

-

ST 2011 ():
, -,
, Killip 3
,

ST 2011 ():
24 ,
, ,
*, PQ >0,24 , - II-III .,

ST 2012 ():

,

ST 2013 ():
24 ,
, ,
*, PQ >0,24 , - II-III .,

IB
IB

IB

IIa B
I
I

* 70, <120, >110, <60,

/ -
:

1- /


1- /

2-

2-

1-

1-2

1-

1-

/
262
B/ 5 + 5 3

( )

( Hg)

- 10-15%


MIAMI (n=5 778)
+ 7

15

(/ 15
200 /)

74,0%

70,1%

<0,05

cA

5,3

4,7

<0,05

Eur Heart J 1985; 6: 199226

/ -
:
:

( , , )


-

ST 2011 ():

/ , Killip <III
ST 2011 ():
(at presentation)
, ,
,
*, PQ >0,24 , - II-III .,

ST 2012 ():
(at presentation)
, , ,
( )

ST 2013 ():
(at presentation)

,

IIa C

IIa

IA

IIa B

* 70, <120, >110, <60,

ST
CADILLAC (n=2 082)
18 + 12 +
(%)
/
15

+

7

-
/

JACC 2004; 43: 1780-7

- ST
PAMI (n=2 537)
12 +

p<0,0148

p=0,11


- **

/
-

/
-

- 48%

<0,0001

- 44%

0,008

- 45%

0,046

** -
1
( -57%)
Am J Cardiol 2003; 91: 655-60



90 32

( )

/


50 2 /


50 2 /

Effect of METOprolol in CARDioproteCtioN During


an Acute Myocardial InfarCtion
The METOCARD-CNIC Trial ( n=220)
18-80 + ST 2
6
/ , /
Killip III-IV, <120, <60 ( PQ >240)
( )

15 3
(50% )
25-100 2 /
12-24

25-100 2 /
12-24

: , ,
, 24 6-12
Am Heart J 2012; 164: 473-480

-
-
>1

6-48
#

95%

5 785

- 29%

15 41%

11 557

- 20%

4 34%

2 084

- 41%

23 54%

1 959

- 23%

2 40%

603

- 51%

7 75%

Brit Med J 1999; 318: 1730-7. Lancet 2001; 357: 1385-90

-
CAPRICORN (n=1 959)

3-21 + 40% 1,3


( )

/ 46%, 86%, 98%


1,3

6,25 ,
4-6
25 2 /

15%

12%

- 23%

0,03

14%

11%

- 25%

0,02

7%

5%

- 26%

0,09

6%

3%

- 41%

0,01

Lancet 2001; 357: 1385-90

-
-
>1

6-48
#

95%

5 785

- 29%

15 41%

11 557

- 20%

4 34%

**

1 959

- 23%

2 40%

*
** 3-21 40%

Brit Med J 1999; 318: 1730-7. Lancet 2001; 357: 1385-90

-
REACH
,



(n=18 653)
+18%


(n=12 012)
-8%

=0,02

-10%*

=0,31

-
-


(n=14 043)

=0,14

-
-

* 1 , , ,
-
-23% (95% 0,64-0,92)
JAMA 2012; 308:1340-9

-

ST 2011 ():
40%
ST 2011 ():
,

(
, , )
ST 2012 ():

,

I
IB
IIa B

IIa B

ST 2013 ():

,

,

, .

.
/
3- .

[]


EPHESUS (n=6 632)
3-14 + 40% +

/ 45%, 88%,
87%, - 75%
16

25 1
4 ,
50 1

16,7%

14,4%

- 15%

0,008

14,6%

12,3%

- 17%

0,005

6,1%

3,9%

- 21%

0,03

11,8%

10,4%

- 15%

0,03

6 /

3,9%

5,5%

0,02

1,5%

0,5%

<0,001


REMINDER (n=1 012)
c ST <24 ( , <12 )
+ <40% +

86%, 5%, 98%


10,5

- 43%

<0,0001

25 1,
50 1
29,6%

18,4%

0,4%

0,4%

0,60

/ -

2,2%

1,4%

0,26

0,6%

40% 1

4,0%

4,2%

0,81

BNP/NT-proBNP 1

25,9%

16,0%

>6 /

0,4%

1,6%

<3,5 /

5,6%

1,4%

,
/ - ,
/, 40% 1 ,
BNP NT-proBNP 1

- 42%

0,0002
0,11

0,0002