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Rosuvastatina e ciprofibrato no tratamento da dislipidemia em pacientes com HIV / Rosuvastatin and ciprofibrate in the treatment of dyslipidemia in patients with HIV
Domingos, Hamilton; Cunha, Rivaldo Venâncio da; Paniago, Anamaria Mello Miranda; Souza, Albert Schiaveto de; Rodrigues, Renata London; Domingos, João Américo.
  • Domingos, Hamilton; Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande. BR
  • Cunha, Rivaldo Venâncio da; Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande. BR
  • Paniago, Anamaria Mello Miranda; Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande. BR
  • Souza, Albert Schiaveto de; Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande. BR
  • Rodrigues, Renata London; Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande. BR
  • Domingos, João Américo; Universidade Federal de Mato Grosso do Sul. Faculdade de Medicina. Campo Grande. BR
Arq. bras. cardiol ; 99(5): 997-1007, nov. 2012. tab
Article in Portuguese | LILACS | ID: lil-656637
RESUMO
FUNDAMENTO A dislipidemia secundária à terapia antirretroviral potente nos pacientes com HIV está associada à significativa elevação da morbimortalidade cardiovascular por doença aterosclerótica, sendo, portanto, necessário tratamento imediato e eficaz.

OBJETIVO:

Demonstrar a efetividade e a segurança da rosuvastatina e do ciprofibrato no tratamento da dislipidemia associada à terapia antirretroviral potente em pacientes com HIV.

MÉTODOS:

Trezentos e quarenta e seis pacientes com dislipidemia foram submetidos a tratamento farmacológico 200 pacientes com hipertrigliceridemia receberam ciprofibrato (Grupo I); 79 pacientes com hipercolesterolemia receberam rosuvastatina (Grupo II); e 67 pacientes com dislipidemia mista receberam ciprofibrato associado a rosuvastatina (Grupo III). O perfil lipídico foi avaliado antes e após o tratamento hipolipemiante, sendo feita comparação estatística pelo teste de Wilcoxon. Transaminases hepáticas e creatinofosfoquinase foram dosadas para controle de toxicidade hepática e muscular.

RESULTADOS:

As concentrações séricas de triglicérides e de colesterol total foram significativamente menores do que as obtidas antes do tratamento, para os três grupos experimentais (p < 0,002). Observou-se aumento significativo do HDL colesterol nos grupos experimentais I e III (p < 0,002). Nos grupos I e II, o LDL-colesterol foi significativamente menor (p < 0,001). Nenhum dos pacientes apresentou elevações de transaminases ou de creatinofosfoquinase a níveis de toxicidade significativa.

CONCLUSÃO:

Os resultados deste estudo demonstram que ciprofibrato, rosuvastatina ou a combinação de ambos pode ser considerada tratamento hipolipemiante efetivo, seguro e com boa tolerância nos pacientes com Aids submetidos à terapia antirretroviral potente.
ABSTRACT

BACKGROUND:

Dyslipidemia secondary to highly active antiretroviral therapy in patients with HIV is associated with a significant increase in cardiovascular morbidity and mortality due to atherosclerotic disease, requiring, thus, immediate and effective treatment.

OBJECTIVE:

To demonstrate the effectiveness and safety of rosuvastatin and ciprofibrate in the treatment of dyslipidemia associated with highly active antiretroviral therapy in patients with HIV.

METHODS:

Three hundred and forty-six patients with dyslipidemia underwent pharmacological treatment as follows 200 patients with hypertriglyceridemia received ciprofibrate (Group I); 79 patients with hypercholesterolemia received rosuvastatin (Group II); and 67 patients with mixed dyslipidemia received ciprofibrate associated with rosuvastatin (Group III). The lipid profile was assessed before and after the lipid-lowering treatment, and the Wilcoxon test was used for statistical comparison. Liver transaminases and creatine phosphokinase were measured to assess liver and muscle toxicity.

RESULTS:

The serum concentrations of triglycerides and total cholesterol were significantly lower than those obtained before the lipid-lowering treatment in the three experimental groups (p < 0.002). A significant increase in HDL-cholesterol was observed in Groups I and III (p < 0.002). In Groups I and II, LDL-cholesterol was significantly lower (p < 0.001). None of the patients experienced elevations in transaminases or creatine phosphokinase to significantly toxic levels.

CONCLUSION:

The results of this study show that ciprofibrate and rosuvastatin or a combination of both can be considered an effective, safe and well-tolerated lipid-lowering treatment for patients with AIDS on highly active antiretroviral therapy.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pyrimidines / Sulfonamides / HIV Infections / Antiretroviral Therapy, Highly Active / Dyslipidemias / Fibric Acids / Fluorobenzenes / Hypolipidemic Agents Type of study: Etiology study / Risk factors Limits: Adult / Female / Humans / Male Language: Portuguese Journal: Arq. bras. cardiol Journal subject: Cardiology Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Mato Grosso do Sul/BR

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Full text: Available Index: LILACS (Americas) Main subject: Pyrimidines / Sulfonamides / HIV Infections / Antiretroviral Therapy, Highly Active / Dyslipidemias / Fibric Acids / Fluorobenzenes / Hypolipidemic Agents Type of study: Etiology study / Risk factors Limits: Adult / Female / Humans / Male Language: Portuguese Journal: Arq. bras. cardiol Journal subject: Cardiology Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal de Mato Grosso do Sul/BR