关注心血管病残余风险

关注心血管病残余风险内容摘要：

万人失明 导 致成人 终 末期 肾病每年新增 44% Cardiovascular Disease 10名糖尿病患者中有 8人死于心血管事件 预 期寿命减少 510年 NIDDK, National Diabetes Statistics fact sheet. HHS, NIH, 2020. Diabetic Nephropathy Stroke Diabetic Neuropathy 糖尿病治疗中相关残余风险 In the STENO2 study, intensive multifactorial intervention significantly reduced the development or progression of diabetesrelated microvascular disease, but failed to prevent this in many patients. Reason for this could being Residual Risk. JEANCHARLES FRUCHART, et al. Diabetes and Vascular Disease Research 2020 Does intensive therapy of type 2 diabetes help or harm? Seeking accord on ACCORD ACCORD study Group. N Engl J Med 2020. JORGE CE, et al. Diabetes Care, 2020. Byron J. Cleveland Clinic Journal of Medicine. 2020 The Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial  强化降糖治疗 : 糖化血红蛋白 A1c 目标值低于 %.  标准降糖治疗 : 糖化血红蛋白 A1c 目标值 % to %. 一级结果（非致命性心梗、卒中、心血管死亡）总发生率比较：强化治疗组低于标准治疗组， 主要归因于强化治疗组非致命性心梗发生率明显低于标准治疗组 （ % vs. %, HR , 95% CI –, P=） 全因死亡率强化治疗组高于标准治疗组 22%（ P=），从而终止该试验 高血压相关残余风险 ACCORD血压试验 Effects of Intensive Blood Pressure Control in the Management of Patients With Type 2 Diabetes Mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial ACCORD Study Group. N Engl J Med March 14, 2020. Giuseppe Mancia. Circulation. 2020. JOSHUA ,et Care, 2020  治疗 1年后平均收缩压比较：标准治疗 强化治疗 ， δ= 强化治疗降低收缩压优于标准治疗 ACCORD Study Group. N Engl J Med March 14, 2020. 平均 SBP: 标准治疗组 ；强化治疗组 Comparison of CVD outes by level of central obesity in the ACCORD Blood Pressure Trial. 强化降压降低卒中发生率，其余事件发生率组间无差异 强化治疗严重不良事件发生率显著增高 冠脉狭窄程度与心血管病事件残余风险 COURAGE study . John Mancini,et al. Circ Cardiovasc Interv. 2020  Angiographic Disease Progression and Residual Risk of Cardiovascular Events While on Optimal Medical Therapy Observations From the COURAGE (Clinical Outes Utilizin。