现代脂质三联治疗课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,二级,三级,四级,五级,*,现代脂质三联治疗课件,*,现代脂质三联治疗,现代脂质三联治疗课件,1,现代脂质三联治疗现代脂质三联治疗课件1,Introduction,Part I,现代脂质三联治疗课件,2,IntroductionPart I现代脂质三联治疗课件2,Efficacy -The Power to Reach Target,Key Factor:,+,Differentiators:,LDL Reduction,TG,HDL,LDL/HDL Ratio,The Lipid Triad,现代脂质三联治疗课件,3,Efficacy -The Power to Reach,The LDL/HDL Ratio-Our Strength,Our Story!,Clear positioning,for Lipobay,A new perception of efficacy,Differentiation to Atorvastatin,Fit with our product profile,现代脂质三联治疗课件,4,The LDL/HDL Ratio-Our Streng,LDL,HDL,Additional risk factor,especially in diabetics,The Lipid Triad-Overview,TG,The Lipid Triad,The Ratio,现代脂质三联治疗课件,5,LDLHDLAdditional risk factor,T,The Lipid Triad,and Strategic Rationale,Part II,现代脂质三联治疗课件,6,The Lipid Triad Part II现代脂质三联治,No scientific evidence,Evidence contradicting this statement,A marketing hypothesis to build their LDL story,Creating the perception of the statin with the,strongest efficacy,The lower.the better?,现代脂质三联治疗课件,7,No scientific evidence The lo,Its logical,Its,measurable,Its,practicable,The Lipid Triad -The GPs Perspective,现代脂质三联治疗课件,8,Its logicalIts measurabl,HDL,LDL,现代脂质三联治疗课件,9,HDLLDL现代脂质三联治疗课件9,Supporting Data,from Landmark Studies,Part III,现代脂质三联治疗课件,10,Supporting Data Part III现代脂质三联,12,10,8,6,4,2,0,%,Mortality,Placebo Q1 Q2 Q3 Q4,(low HDL-increase)(high HDL-increase),4,S-Study,CAD Mortality per Quartiles of Increases in HDL-Cholesterol,KJEKSHUS J&PEDERSEN T(unpublished),现代脂质三联治疗课件,11,12%MortalityPlacebo,HDL Intervention Trial(VA-HIT),RUBINS HB et al.New Engl J Med 1999;341:410,0,6,-31,-4,-35,-30,-25,-20,-15,-10,-5,0,5,10,Cholesterol LDL-C HDL-C Triglycerides,Percent change compared,to placebo at 1 year,Secondary Prevention in 2531 menwith low HDL-C&LDL-C showed a22%reduction in combined fataland non-fatal MI,现代脂质三联治疗课件,12,HDL Intervention Trial(VA-HIT,HDL-Cholesterol as Risk Factor for CHD,LRC-CPPT(Placebo),MRFIT(usual care),Incidence rate of CHD,Incidence rate of CHD,12,10,8,6,4,2,0,100 130 160 190,GORDON DJ et al.Circulation 1989;79:8-15.,HDL-C,mg/dl,65,55,45,35,LDL-Cholesterol mg/dl,LDL-Cholesterol mg/dl,12,10,8,6,4,2,0,100 130 160 190,现代脂质三联治疗课件,13,HDL-Cholesterol as Risk Fact,0,0.5,1,1.5,2,2.5,3,Framingham Heart Study,CAD risk as a function of LDL-C and HDL-C,in men(50 to 70 y),CASTELLI WP.Am J Cardiol 1998;82:60-65,220 160 100,85,65,45,25,HDL-Cholesterol,(mg/dl),LDL Cholesterol(mg/dL),现代脂质三联治疗课件,14,00.511.522.53Framingham Heart,0,2,4,6,8,10,12,14,16,LDL5,HDL=1.08,HDL1.08,LDL/HDL5,Incidence of cardiac events,(,per 1000 person-years),Gemfibrozil,Placebo,LDL-C Tertiles(mmol/L),HDL-C Tertiles(mmol/L),LDL-C/HDL-C Tertiles,24,46,32,36,34,45,22,39,38,53,18,29,Incidence for cardiac events vs lipid parameter,Helsinki Heart Study,MANNINEN V,Leena T,Koskinen P et al.Circulation 1992;85:37-45,现代脂质三联治疗课件,15,0246810121416LDL5HDL=1,AFCAPS/TEXCAPS,Apo B/A1 Tertiles,LDL-C/HDL-C Tertiles,1.6,1.4,1.2,1,0.8,0.6,0.4,0.2,0,1.6,1.4,1.2,1,0.8,0.6,0.4,0.2,0,Event Rate per 100 Patient-Years of Risk,Event Rate per 100 Patient-Years of Risk,0.8889,0.8898-,1.0205,1.0252,3.7742,3.7744-4.4096,4,.4101,GOTTO A et al.Circulation 2000;101:477-484,LDL/HDL Ratio as Therapeutic Success,Placebo,Statin,现代脂质三联治疗课件,16,AFCAPS/TEXCAPS Apo B/A1 Tertil,24,116,31,245,0,50,100,150,200,250,300,5,LDL/HDL-Ratio,Triglycerides=200 mg/dl,CAD cases per 1,000 subjects in 6 years,ASSMANN G and SCHULTE H;Am J Cardiol 1992;70:733-737,Incidence of CAD vs LDL/HDL ratio by TG level(n=4559),PROCAM Heart Study,现代脂质三联治疗课件,17,2411631245050100150200250300=,0,50,100,150,200,250,300,3,4,5,6,7,LDL/HDL ratio,CHD Incidence/1000 in 6 years,CHD risk according to LDL/HDL ratio at baseline,ASSMANN G;Lipid Metabolism Disorders and CHD;MMV Medizin Verlag,1993:43,5,High,CHD risk,Medium,CHD risk,Low,CHD risk,3-5,3,PROCAM Heart Study,现代脂质三联治疗课件,18,0501001502002503005,Mean values for developing atherosclerotic CHD within 6 years,Variable CHD Development No CHD Development,(n=186)(n=4221),TC(mg/dl)251.8222.9,HDL-C(mg/dl)39.5 45.2,LDL-C(mg/dl)176.2 147.1,LDL/HDL ratio 4.72 3.4,TG(mg/dl)163.0134.5,ASSMANN G;Lipid Metabolism Disorders and CHD;MMV Medizin Verlag,1993:41,PROCAM Heart Study,现代脂质三联治疗课件,19,Mean values for developing ath,Predictive value of risk factors for developing atherosclerotic,CHD within 6 years,Variable Risk RatioPredictive Power%,TG,200,mg/dl2.3 7.5,TC,250,(mg/dl)2.8 8.3,LDL-C,195(mg/dl)3.7 12.0,LDL-C,155(mg/dl)3.3 7.1,HDL-C,35,(mg/dl)3.911.0,LDL/HDL ratio,56.416.5,ASSMANN G;Lipid Metabolism Disorders and CHD;MMV Medizin Verlag,1993:43,PROCAM Heart Study,现代脂质三联治疗课件,20,Predictive value of risk facto,HDL as CHD risk factor showed 186 events,in men aged 40-60 years(n=4407),CHD Incidence per 1,000 in 6 years,0,20,40,60,80,100,120,140,160,35 35-55,55,HDL-C(mg/dL),110,30,21,ASSMANN G;Lipid Metabolism Disorders and CHD;MMV Medizin Verlag,1993:59,PROCAM Heart Study,现代脂质三联治疗课件,21,HDL as CHD risk factor showed,LDL as CHD risk factor showed 177 events,in men aged 40-60 years,(n=4263),CHD Incidence per 1,000 in 6 years,0,20,