0000000000282349
AUTHOR
Teresa Mantilla
Residual cardiovascular risk of lipid origin. Components and pathophysiological aspects
Abstract There is no doubt about the relationship between LDL-C and cardiovascular risk, as well as about the benefits of statin treatment. Once the objective of LDL-C has been achieved, the evidences that demonstrate the persistence of a high cardiovascular risk, a concept called residual risk, are notable. The residual risk of lipid origin is based on atherogenic dyslipidemia, characterised by an increase in triglycerides and triglyceride-rich lipoproteins, a decrease in HDL-C and qualitative alterations in LDL particles. The most commonly used measures to identify this dyslipidemia are based on the determination of total cholesterol, triglycerides, HDL, non-HDL cholesterol and remaining …
Enfermedad del hígado graso no alcohólico, asociación con la enfermedad cardiovascular y tratamiento (II). Tratamiento de la enfermedad del hígado graso no alcohólico
Disease nonalcoholic fatty liver disease (NAFLD) comprises a series of histologically similar to those induced by alcohol consumption in people with very little or no liver damage same. The importance of NAFLD is its high prevalence in our Western societies, from the point of view liver in its progressive evolution from steatosis to steatohepatitis, cirrhosis and liver cancer. During the last decade it has been observed that NAFLD leads to an increased cardiovascular risk with accelerated atherosclerosis and cardiovascular events, the leading cause of morbidity and mortality. This updated January 2016 revision consists of two parts. In this second part, the treatment of NAFLD and its influe…
La auténtica dimensión del colesterol-no-HDL: colesterol aterogénico
Lowe density lipoproteins (LDL) are the causal agent of cardiovascular diseases. In practice, we identify LDL with cholesterol transported in LDL (cLDL). So, cLDL has become the major target for cardiovascular prevention. Howewer, we have progressive evidences about the role of triglycerides rich lipoproteins, particularly those very low density lipoprotein (VLDL) in promotion and progression of atherosclerosis, that leads cholesterol in VLDL and its remanents as a potential therapeutic target. This feature is particularly important and of a great magnitude, in patients with hypertiglyceridemia. We can to considere, that the non-HDL cholesterol -cLDL+cVLDL+c-remmants+Lp(a)- is the real meas…
Decálogo de recomendaciones clínicas en dislipidemia aterogénica
, fue realizado con el fin de promover ydesarrollar un consenso experto mediante la integracionde la mejor evidencia disponible y la experiencia de unamplio panel de profesionales de diferentes especialidadesmedicas. Para ello se empleo el metodo Delphi, una tecnicade consenso profesional mediante encuesta, fiable y delarga tradicion de uso en la investigacion biomedica, quepermite explorar y unificar las opiniones de un grupoprofesional sobre el tema de interes, sin las dificultades einconvenientes inherentes a los metodos de consenso condiscusion presencial
Nonalcoholic fatty liver disease, association with cardiovascular disease and treatment (II). The treatment of nonalcoholic fatty liver disease.
Disease nonalcoholic fatty liver disease (NAFLD) comprises a series of histologically similar to those induced by alcohol consumption in people with very little or no liver damage same. The importance of NAFLD is its high prevalence in our Western societies, from the point of view liver in its progressive evolution from steatosis to steatohepatitis, cirrhosis and liver cancer. During the last decade it has been observed that NAFLD leads to an increased cardiovascular risk with accelerated atherosclerosis and cardiovascular events, the leading cause of morbidity and mortality. This updated January 2016 revision consists of two parts. In this second part, the treatment of NAFLD and its influe…
Enfermedad del hígado graso no alcohólico, asociación con la enfermedad cardiovascular y tratamiento ( I ). Enfermedad del hígado graso no alcohólico y su asociación con la enfermedad cardiovascular
Non-alcoholic fatty liver disease (NAFLD) comprises a series of histologically lesions similar to those induced by alcohol consumption in people with very little or no liver damage. The importance of NAFLD is its high prevalence in the Western world and, from the point of view of the liver, in its gradual progression from steatosis to steatohepatitis, cirrhosis, and liver cancer. During the last decade it has been observed that NAFLD leads to an increased cardiovascular risk with acceleration of arteriosclerosis and events related to it, being the main cause of its morbidity and mortality. This review, updated to January 2016, consists of two parts, with the first part analysing the associa…
Riesgo de interacciones farmacológicas por la coadministración de estatinas con fármacos metabolizados por la isoenzima 3A4 del citocromo P450: estudio epidemiológico, transversal y multicéntrico
Resumen Fundamento y objetivo Las estatinas son farmacos seguros, pero con un elevado riesgo de interacciones farmacologicas. El objetivo del estudio fue evaluar la prevalencia de interacciones potenciales en la isoenzima 3A4 del citocromo P450 (CYP3A4), en una amplia muestra de pacientes tratados con estatinas, y determinar los factores asociados, tanto del paciente como del medico prescriptor. Pacientes y metodo Estudio observacional, transversal, de base poblacional. Fueron seleccionados 7.880 sujetos en tratamiento con estatinas. Se recogieron datos referentes a los pacientes y a los 1.681 medicos participantes. Resultados Un 59% de los pacientes recibia estatinas metabolizadas por el C…
Riesgo cardiovascular residual de origen lipídico. Componentes y aspectos fisiopatológicos
Resumen Es indudable la relacion del cLDL y el riesgo cardiovascular, asi como de los beneficios del tratamiento con estatinas. Una vez conseguido el objetivo de cLDL, son notables las evidencias que demuestran la persistencia de un elevado riesgo cardiovascular, concepto denominado riesgo residual. El riesgo residual de origen lipidico se fundamenta en la dislipidemia aterogenica, caracterizada por un aumento de trigliceridos y de las lipoproteinas ricas en trigliceridos, un descenso del cHDL y alteraciones cualitativas de las particulas LDL. Las medidas mas utilizadas para identificar esta dislipidemia se basan en la determinacion de colesterol total, trigliceridos, HDL, colesterol no HDL…
Documento de consenso sobre el manejo de la dislipemia aterogénica de la Sociedad Española de Arteriosclerosis
Resumen Documento de posicionamiento y resumen de las recomendaciones recientemente publicadas por el Grupo de Trabajo de Dislipemia Aterogenica de la Sociedad Espanola de Arteriosclerosis y por la Sociedad Europea de Arteriosclerosis.
Consensus document on the management of the atherogenic dyslipidaemia of the Spanish Society of Arteriosclerosis.
Positioning document and summary of recommendations recently published by the Working Group on Atherogenic Dyslipemia of the Spanish Society of Arteriosclerosis and by the European Society of Arteriosclerosis.
Los fibratos en la prevención primaria de la enfermedad cardiovascular. Comentarios a los resultados de una revisión sistemática de la Colaboración Cochrane
Resumen Los fibratos son un grupo de hipolipidemiantes que reducen los trigliceridos, elevan las lipoproteinas de alta densidad y disminuyen la fraccion de particulas de LDL pequenas y densas. Recientemente, se han publicado los resultados de un estudio de la Colaboracion Cochrane sobre su eficacia y seguridad en la prevencion primaria de la enfermedad cardiovascular. Este estudio incluye una revision sistematica y un metaanalisis de 6 estudios (16.135 pacientes) que evaluan, en personas en prevencion primaria, los beneficios clinicos de los fibratos comparados con el uso de un placebo o de otros hipolipidemiantes. Concluyen que, comparados con placebo, los fibratos son utiles para reducir …
Colesterol-no HDL como objetivo terapéutico
Although cholesterol linked to low-density lipoproteins (c-LDL) is well established as a risk factor for cardiovascular disease, there is often a more complex dyslipidaemia pattern that contributes to the formation of atherosclerotic plaque. Non-HDL cholesterol (c-NO-HDL) is used to estimate the total amount of atherogenic lipoproteins in plasma, some of which are not usually determined in daily clinical practice. c-NO-HDL is easily calculated from the subtraction of total plasma cholesterol from the cholesterol content carried by high density lipoproteins. The c-NO-HDL has a predictive value superior to that of C-LDL to estimate the risk of major cardiovascular events in epidemiological st…
Nonalcoholic fatty liver disease, association with cardiovascular disease and treatment. (I). Nonalcoholic fatty liver disease and its association with cardiovascular disease.
Non-alcoholic fatty liver disease (NAFLD) comprises a series of histologically lesions similar to those induced by alcohol consumption in people with very little or no liver damage. The importance of NAFLD is its high prevalence in the Western world and, from the point of view of the liver, in its gradual progression from steatosis to steatohepatitis, cirrhosis, and liver cancer. During the last decade it has been observed that NAFLD leads to an increased cardiovascular risk with acceleration of arteriosclerosis and events related to it, being the main cause of its morbidity and mortality. This review, updated to January 2016, consists of two parts, with the first part analysing the associa…
Fibrates in primary prevention of cardiovascular disease. Comments on the results of a systematic review of the Cochrane Collaboration
Abstract Fibrates are drugs that reduce triglycerides, elevate high-density lipoproteins, as well as decrease small, dense LDL particles. The results of a study have recently been published by the Cochrane Collaboration on fibrates efficacy and safety in the primary prevention of cardiovascular disease. This study includes a systematic review and a meta-analysis of 6 studies (16,135 patients) that evaluated the clinical benefits of fibrates compared to placebo use or other lipid-lowering drugs. This review showed evidence of a protective effect of the fibrates compared with placebo as regards a reduction 16% of a compound objective of death due to cardiovascular disease, non-fatal myocardia…