Assuntos
Cardiomiopatias/diagnóstico , Hiperamonemia/diagnóstico , Imageamento por Ressonância Magnética , Doenças Musculares/diagnóstico , Miocárdio/patologia , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/terapia , Cardiomiopatias/sangue , Cardiomiopatias/complicações , Cardiomiopatias/patologia , Cardiomiopatias/terapia , Carnitina/sangue , Carnitina/deficiência , Carnitina/uso terapêutico , Meios de Contraste , Morte Súbita Cardíaca/etiologia , Morte Súbita Cardíaca/prevenção & controle , Desfibriladores Implantáveis , Suplementos Nutricionais , Ecocardiografia , Cardioversão Elétrica/instrumentação , Feminino , Humanos , Hiperamonemia/sangue , Hiperamonemia/complicações , Hiperamonemia/patologia , Hiperamonemia/terapia , Doenças Musculares/sangue , Doenças Musculares/complicações , Doenças Musculares/patologia , Doenças Musculares/terapia , Valor Preditivo dos Testes , Resultado do Tratamento , Adulto JovemRESUMO
Almost one third of annual worldwide mortality is attributed to cardiovascular disease (CVD), making it the leading cause of global death. Dyslipidemia is a well-established risk factor for CVD and plays a pivotal role in the pathogenesis of atherosclerosis. Statins, which inhibit 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and lower low-density lipoprotein cholesterol, have emerged as the most effective therapy to date against atherothrombotic CVD. Although their role in secondary prevention of CVD is undisputed, it remains a topic for debate as to how widely they should be used for primary prevention. The Framingham Risk Score and the National Cholesterol Education Program Adult Treatment Panel III guidelines are the cornerstones for the current guidelines for primary prevention statin therapy. Although these guidelines serve as help to evaluate cardiovascular risk and effectively identify many patients who will benefit from statin therapy, there is a growing population of "intermediate-risk" patients who may be undertreated. Additional noninvasive tests may complement the traditional risk scores, potentially expanding the indications for statins.