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Resumen La enfermedad cardiovascular aterosclerótica (infarto de miocardio, accidente cerebrovascular y enfermedad arterial periférica) continúan siendo las causas más importantes de muerte prematura, discapacidad y gastos en atención médica en todo el mundo. Por lo tanto, evitar la acumulación vascular de lipoproteínas aterogénicas de colesterol es fundamental para prevenir los eventos cardiovasculares mayores. La actualización de la ruta colombiana del colesterol, Colombian Cholesterol Roadmap, es el resultado de la reunión realizada en el Congreso Nacional de Cardiología 2023, con el apoyo de la Federación Mundial del Corazón y una mesa de expertos clínicos, temáticos y representantes de diferentes instituciones relacionadas con el manejo de las dislipidemias en Colombia. Este documento tiene como objetivo ser un marco conceptual para describir los hallazgos y logros obtenidos a partir de las mesas de trabajo relacionadas con la identificación de barreras que limitan el tratamiento adecuado de la hipercolesterolemia en Colombia y las acciones que fueron propuestas ajustadas al contexto local que buscan desarrollar políticas nacionales y enfoques en nuestros sistemas de salud. Así mismo, confirma el compromiso del trabajo articulado intersectorial para lograr las metas en salud cardiovascular propuestas para el año 2030.
Abstract Atherosclerotic cardiovascular diseases (including myocardial infarction, stroke, and peripheral arterial disease) continue to be a leading cause of premature death, disability, and healthcare expenditures worldwide. Therefore, preventing the vascular accumulation of atherogenic cholesterol-containing lipoproteins is crucial in averting major cardiovascular events. The Colombian Cholesterol Roadmap update is the outcome of a meeting held during the 2023 National Cardiology Congress, with the support of the World Heart Federation and a panel of clinical and thematic experts, along with representatives from various institutions involved in the management of dyslipidaemias in Colombia. The present update of this Cholesterol Roadmap provides a conceptual framework to describe the findings and achievements derived from working groups focused on identifying barriers that hinder the appropriate treatment of hypercholesterolemia in Colombia. It also outlines proposed actions adjusted to the local context, aiming to develop national policies and approaches within our healthcare systems. Furthermore, it reaffirms the commitment to intersectoral collaboration to achieve the cardiovascular health goals set for the year 2030.
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New techniques in clinical lipid measurements, such as vertical auto profile, nuclear magnetic resonance spectroscopy, electrospray differential mobility analysis and liquid chromatography-mass spectrometry/mass spectrometry, are becoming increasingly mature. Clinical application of these new techniques significantly promoted the use of new lipid parameters including the particle concentrations of low-density lipoprotein/high-density lipoprotein and other lipoprotein subtype in the risk stratification of atherosclerotic cardiovascular disease and in the efficacy monitoring of lipid-regulating therapy, above progress is helpful on developing new individualized and precise lipid management strategies. This review analyzed and summarized the research progress of the new techniques for lipid measurements in recent years, aiming to provide evidence to develop new ideas for the individualized and accurate lipid management in clinical practice.
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OBJECTIVE@#To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.@*METHODS@#We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases (ASCVD) among 8,252 participants aged ⪖ 40 years without diabetes from Jiading district, Shanghai, China.@*RESULTS@#Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid (all P trend < 0.05). Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia (all P trend < 0.05). A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios (ORs) [95% confidence intervals (CIs)] for the highest quartiles for high Framingham risk were 3.00 (2.00-4.50) in men and 2.95 (1.08-8.43) in women. The multivariate adjusted ORs (95% CIs) for the highest quartile for high ASCVD risk were 1.93 (1.17-3.17) in men and 4.53 (2.57-7.98) in women.@*CONCLUSION@#Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dyslipidemia, 10-year Framingham risk for coronary heart disease, and 10-year risk for ASCVD among Chinese adults without diabetes.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Biomarcadores , Sangue , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , China , Doença das Coronárias , Sangue , Epidemiologia , Estudos Transversais , Hemoglobinas Glicadas , Lipídeos , Sangue , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Fatores Sexuais , Ácido Úrico , SangueRESUMO
<b>Objective:</b> The aim of the study was to assess the effect of rosuvastatin 2.5 mg, an inhibitor of HMG-CoA reductase, on achieving lipid goals defined by the 2007 Japan Atherosclerosis Society guidelines.<br> <b>Subjects and Methods:</b> Thirty-seven patients with moderate to high risk hypercholesterolemia (Mean age: 64.8 ± 8.4) were treated with 2.5 mg/day of rosuvastatin and their lipid and hepatic function parameters were measured at the baseline and at Weeks 4 and 8.<br> <b>Results:</b> At 4 and 8 weeks after start of treatment, 74.1% and 92.6% of moderate risk patients, as well as 70% and 80% of high risk patients, achieved their LDL-C goals, respectively. In both moderate and high risk patients, the mean LDL-C/HDL-C ratio, which is considered as a prospective index for plaque regression, was significantly reduced (p<0.001 for both the moderate and high risk groups), and the mean LDL-C/HDL-C ratio decreased to less than 2 in moderate risk patients. No abnormal changes were observed in hepatic function tests during the study.<br> <b>Conclusion:</b> More than 80% of moderate to high risk patients with hypercholesterolemia achieved their lipid goals and the mean LDL-C/HDL-C ratio was significantly reduced after the 8-week short treatment of rosuvastatin 2.5 mg, suggesting the clinical possibility of continuous use of rosuvastatin for plaque regression.<br>