心房颤动抗栓治疗进展共享精品ppt课件.ppt

ACTIVE is a phase III, multicenter, multinational, parallel randomized controlled evaluation of clopidogrel plus ASA, with factorial evaluation of irbesartan, for the prevention of vascular events in patients with atrial fibrillation. Patients will be enrolled over 2 years and followed to common termination date (expected to be about 4 years after enrollment of the first patient). About 14,000 patients will be included in the ACTIVE W or ACTIVE A trials. Due to the partial factorial design, patients will only be randomized in ACTIVE I once first randomized into either ACTIVE A or ACTIVE W. Three separate but related trials are included in the ACTIVE study. These are known as ACTIVE W, ACTIVE A, and ACTIVE I. ACTIVE W (n= 6,500): A multicenter, prospective, randomized, non-inferiority trial of clopidogrel plus ASA versus standard care oral anticoagulation (open trial with blinded outcome evaluation). ACTIVE A (n= 7,500): A multicenter, randomized, double-blind, placebo-controlled superiority trial of clopidogrel plus ASA versus ASA alone. ACTIVE I (n= at least 10,000): A multicenter, partial factorial, randomized, double-blind, placebo-controlled superiority trial of irbesartan. 新型抗凝药物 TFPI (tifacogin) FondaparinuxIdraparinux RivaroxabanLY517717YM150 DU-176b XimelagatranDabigatran ORAL PARENTERAL DX-9065a Xa IIa TF/VIIa X IX IXa VIIIa Va II Fibrin Fibrinogen AT APC (drotrecogin alfa) sTM (ART-123) Adapted from Weitz Bates. J Thromb Haemost 2005 TTP889 Ximelagatran不良事件－肝酶升高 CP1108596-20 治疗时间 (月) Event rate (%) ALT 3 x ULN 6.5 0.7 P0.001 发生率 Ideal anticoagulant for the prophylaxis of stroke in atrial fibrillation patients 新型抗凝药物-利伐沙班 2% 华法林 60% 无抗凝 阿司匹林38% 中国心房颤动抗栓治疗现状 胡大一等。中华内科杂志，2004； 孙艺红等。中华内科杂志，2004；43：258-260 9.64%华法林 90.36% 非抗凝 人群流调 住院病人 抗凝治疗的管理 抗凝门诊 [1] 患者手提式自我监测仪 [2,3] 计算机辅助 [4,5] [1] Arch Intern Med 1998;158:1641-7 [2] Thromb Haemost 2000;839:661-5 [3] Lancet 2000;356:97-102 [4] Lancet 1998;352:1505-9 [5] Throm