Lipoproteína de alta densidad como marcador de riesgo residual en pacientes tratados con estatinas: prevalencia y trascendencia clínica / High-density lipoprotein as a marker of residual risk in patients treated with statins: prevalence and clinical importance

El tratamiento con estatinas reduce el riesgo relativo de presentar un episodio coronario en alrededor de un 30%, persistiendo, por lo tanto, un elevado riesgo residual. Hay datos procedentes de estudios epidemiológicos, angiográficos y de intervención que sugieren que el incremento del colesterol unido a lipoproteínas de alta densidad (cHDL) podría reducir el riesgo residual. Aproximadamente, 1 de cada 4 pacientes con cardiopatía isquémica crónica presenta valores de cHDL bajos, independientemente del empleo de estatinas, siendo más frecuentes en mujeres, diabéticos y pacientes con criterios de síndrome metabólico. Por lo tanto, un alto porcentaje de pacientes con cardiopatía isquémica crónica se podría beneficiar de intervenciones dirigidas a elevar el cHDL (AU)

Statin treatment reduces the relative risk of a coronary event by approximately 30% and consequently a high residual risk persists. Data from epidemiological, angiographic and intervention studies suggest that this residual risk could be reduced by increasing highdensity lipoprotein cholesterol (HDL-c). Approximately one out of every four patients with chronic ischemic heart disease has low HDL-c concentrations, independently of the use of statins. In this population low HDL-c levels are most frequent in women, patients with diabetes and those with criteria of metabolic syndrome. Therefore, a high percentage of patients with chronic ischemic heart disease could benefit from interventions aimed at increasing HDL-c levels (AU)

¿Se deben recomendar antioxidantes para la prevención cardiovascular? / Should antioxidants be recommended for cardiovascular prevention?

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[The parenteral drug addict in the emergency service]. / El adicto a drogas por vía parenteral en el servicio de urgencias.

Clinical and epidemiological features of intravenous drug addicts (IVDA), who attended the emergency department between 1984 and 1988, were studied. The number of cases treated over these 4 years had increased three-fold (256 vs 724). The median age had increased by 3 years (p less than 0.01). The sex ratio had not changed. A third of the cases knew that they were HIV-seropositive in 1988. The main reason for consultation in 1984 was overdosage and in 1988 it was fever. The rate of admission was similar in both years (around 21%). There was a significant increase in admissions caused by respiratory diseases in 1988 (p less than 0.0001) and a significant decrease of admissions caused by overdosage (p less than 0.001).

[Necrotizing vasculitis of the panarteritis nodosa type in a long-course primary Sjögren's syndrome]. / Vasculitis necrotizante tipo panarteritis nodosa en un síndrome de Sjögren primario de larga evolución.

Vasculitis is a complication happening in a third of patients with primary Sjögren's Syndrome. It can be of 2 types: neutrophilic or mononuclear and sometimes mixed. Very occasionally, a necrotizing vasculitis polyarteritis nodosa type during the evolution of Sjögren's Syndrome has appeared. A case of a female patient with a Sjögren's Syndrome of large evolution, who suddenly showed a poly-systemic affliction (nervous system, kidneys, muscles and digestive system) secondary to a necrotizing vasculitis type polyarteritis nodosa with a good response to immunosuppressors, is presented.