Cabalé VMB, Sánchez SD

Language: Spanish
References: 20
Page: 119-126
PDF size: 117.78 Kb.

ABSTRACT

Introduction: The benefits of strict lipid control have become evident in primary and secondary prevention studies.
Objective: Determine whether there is an association between lipid control and the absence of adverse coronary events in a five-year period.
Methods: A prospective observational study was conducted with 424 patients cared for at the Dyslipidemia Service of the Cardiology and Cardiovascular Surgery Institute. All patients underwent lipidograms, and the risk category was used as a basis to determine whether they had managed to control their lipid levels during follow-up. Odds ratios were estimated to determine risk by logistic regression, whereas the Kaplan-Meier test was used for event-free survival. The difference between the groups was determined with the Cox-Mantel test.
Results: An association was found between lipid control and the absence of coronary events during follow-up (p = 0.02). The need for myocardial revascularization was more common in the non-control group (p = 0.03). No association was found between the values for each lipid variable and the risk for adverse events. A history of ischemic heart disease was the only factor that showed a relationship to the incidence of coronary events.
Conclusions: Despite the fact that during follow-up there was a relationship between control of lipid levels and the absence of coronary events, no association was observed between the values for each lipoprotein and the occurrence of adverse coronary events.

REFERENCES

1. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, et al. Guía europea sobre prevención de la enfermedad cardiovascular en la práctica clínica (versión 2012). Rev Esp Cardiol. 2012;65(10):937.e1-e66.

2. Anuario estadístico de salud 2014. Ministerio de Salud Pública. La Habana; 2015.

3. Morrone D, Weintraub WS, Toth PP. Lipid-altering efficacy of ezetimibe plus statin and statin monotherapy and identification of factors associated with treatment response: pooled analysis of over 21000 subjects from 27 clinical trials. Atherosclerosis. 2012;223:251–61.

4. Reiner Z, Catapano AL, DeBacker G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guide lines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–818.

5. Stone NJ, Robinson J, Lichtenstein AH, Merz CN, Blum CB, Eckel RH, et al. ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation; 2013.

6. National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand. Reducing risk in heart disease: an expert guide to clinical practice for secondary prevention of coronary heart disease. Melbourne: National Heart Foundation of Australia; 2012.

7. National Vascular Disease Prevention Alliance. Guidelines for the management of Absolute cardiovascular disease risk; 2012.

8. Anderson TJ, Gregoire J, Hegele RA, Couture P, Mancini GB, McPherson R,et al. Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2013;29:151–67.

9. Cabalé Vilariño MB, Sánchez Serrano D, Flores Sánchez A. Control lipídico en pacientes dislipidémicos: Su asociación con complicaciones cardiovasculares. Rev cubana med. 2006 Sep [citado 30 Mar 2015];45(3):[aprox. 16 p.].

10. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation,and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)—Final report. Circulation. 2002;106:3143–421.

11. Fatema K, Zwar NA, Zeba Z, Milton AH, Rahman B, Ali L. Clinical and biochemical characterization of high risk and not high risk for cardiovascular disease adults in a population from peripheral region of Bangladesh. BMC Public Health. 2015;15:559. doi: 10.1186/s12889-015-1919-7.

12. Cannon CP, Braunwald E, McCabe CH, Rader DJ, Rouleau JL, Belder R, et al. Pravastatin or Atorvastatin Evaluation and Infection Therapy - Thrombolysis in Myocardial Infarction 22 Investigators. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med. 2004;350:1495–504.

13. Grundy SM, Cleeman JI, Bairey Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. For the Coordinating Committee of the National Cholesterol Education Program. Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation. 2004;110:227-39.

14. Gotto AM, Barrett-Connor E, Ganz P, Grundy SM, Haffner SM, Krauss RM, et al. Aggressive Lipid Lowering: The latest clinical trial results and their significance for practice. Lipid Management. 2005;10(1):1-8.

15. Okamura T, Hayakawa T, Kadowaki T, Kita Y, Okayama A, Ueshima H, et al. The inverse relationship between serum high-density lipoprotein cholesterol level and all-cause mortality in a 9.6-year follow-up study in the Japanese general population. Atherosclerosis. 2006;184:143-50.

16. Okamura T, Kokubo Y, Watanabe M, Higashiyama A, Miyamoto Y, Yoshimasa Y, et al. Low-density lipoprotein cholesterol and non-high density lipoprotein cholesterol and the incidence of cardiovascular disease in an urban Japanese cohort study: The Suita study. Atherosclerosis. 2009;203:587-92.

17. Thomopoulos C, Skalis G, Michalopoulou H, Tsioufis C, Makris T. Effect of Low- Density Lipoprotein Cholesterol Lowering by Ezetimibe/Simvastatin on Outcome Incidence: Overview, Meta-Analyses, and Meta-Regression Analyses of Randomized Trials. Clin Cardiol. 2015 Aug 18. doi: 10.1002/clc.22441.

18. Kausik KR, Sreenivasa R, Sebhat E, Sever P, Jukema W, Ford I, et al. Statins and All-Cause Mortality in High-Risk Primary Prevention. Arch Intern Med. 2010;170(12):1024-31.

19. DahabrehI J, Kent DM. Index event bias as an explanation for the paradoxes of recurrence risk research. JAMA. 2011;305:822–3.

20. Beatty Alexis L, Ku IA, Bibbins-Domingo K, Christenson RH, De Filippi CR, Ganz P. Traditional Risk Factors Versus Biomarkers for Prediction of Secondary Events in Patients With Stable Coronary HeartDisease: From the Heart and Soul Study. J Am Heart Assoc. 2015;4:e001646 doi: 10.1161/JAHA.114.001646.