Eficacia de la terapia con estatinas para la prevencion primaria y secundaria de accidente cerebrovascular isquemico, revision y evidencia cientifica disponible
Resumen
Antecedentes y objetivos: Evaluar el efecto de la terapia hipolipemiante basada en estatinas en el accidente cerebrovascular isquémico en ensayos de prevención primaria y secundaria con respecto a los niveles alcanzados de colesterol de lipoproteínas de baja densidad en vista de la disponibilidad de nuevos agentes hipolipidémicos potentes.
Métodos: se buscó en la literatura inglesa (hasta 2018) las publicaciones mas actualizadas y disponibles hasta el momento.
Resultados: El tratamiento hipolipemiante se asoció con un menor riesgo de accidente cerebrovascular isquémico en la prevención primaria (cociente de riesgos, RR 0,70, intervalo de confianza del 95 %, IC, 0,60–0,82; p < 0,001) y en la prevención secundaria (RR 0,80, IC del 95 % 0,70-0,90; p < 0,001). El procedimiento de estimación de la curva reveló una relación lineal entre la reducción del riesgo absoluto de accidente cerebrovascular isquémico y el tratamiento activo, se logró niveles de colesterol de lipoproteínas de baja densidad ajustados según las guias en prevención secundaria (R-cuadrado ajustado 0,90) en apoyo de la hipótesis de "cuanto más bajo, mejor" para sobrevivientes de accidentes cerebrovasculares. Por otro lado, el modelo cúbico siguió bien los datos observados en prevención primaria (R-cuadrado ajustado 0,98), lo que indica una mayor reducción del riesgo absoluto en individuos libres de enfermedad cardiovascular.
Conclusiones: Los hipolipemiantes basados en estatinas son efectivos tanto para la prevención primaria como secundaria del ictus isquémico. La mayor parte del beneficio se deriva de dirigirse a individuos libres de enfermedad con alto riesgo cardiovascular y al lograr objetivos de tratamiento adecuados para los niveles de lipoproteínas de baja densidad en prevencion primaria y sobrevivientes de accidentes cerebrovasculares.
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Derechos de autor 2025 María Alejandra Velásquez Quiroga , Vanya Esther Vargas Vargas , Ingrith Salas Hine , Cristian Camilo Ballesteros López, Maira Alejandra Puerta Medina , Jonatan Ferley Vasquez Castro, Wendis Esther García Ortiz , Bleydis Loraine Pelaez Lobo , Aura Michell Pacheco Quintero, Ricardo Jose Silvera Rada
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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