{"id":252756,"date":"2025-01-21T13:29:29","date_gmt":"2025-01-21T12:29:29","guid":{"rendered":"https:\/\/r3i.org\/hito-mas-pruebas-que-relacionan-el-colesterol-remanente-y-los-resultados-cardiovasculares\/"},"modified":"2025-02-15T22:08:24","modified_gmt":"2025-02-15T21:08:24","slug":"hito-mas-pruebas-que-relacionan-el-colesterol-remanente-y-los-resultados-cardiovasculares","status":"publish","type":"page","link":"https:\/\/r3i.org\/es\/hito-mas-pruebas-que-relacionan-el-colesterol-remanente-y-los-resultados-cardiovasculares\/","title":{"rendered":"Hito – M\u00e1s pruebas que relacionan el colesterol remanente y los resultados cardiovasculares"},"content":{"rendered":"

[et_pb_section fb_built=\u00bb1″ _builder_version=\u00bb4.27.4″ _module_preset=\u00bbdefault\u00bb custom_padding=\u00bb1px|||||\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_row _builder_version=\u00bb4.27.4″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_column type=\u00bb4_4″ _builder_version=\u00bb4.27.4″ _module_preset=\u00bbdefault\u00bb global_colors_info=\u00bb{}\u00bb][et_pb_text _builder_version=\u00bb4.27.4″ _module_preset=\u00bbdefault\u00bb header_2_text_color=\u00bbgcid-primary-color\u00bb header_5_text_color=\u00bbgcid-secondary-color\u00bb text_orientation=\u00bbcenter\u00bb width=\u00bb99%\u00bb custom_margin=\u00bb|-147px||||\u00bb custom_padding=\u00bb|0px||||\u00bb hover_enabled=\u00bb0″ global_colors_info=\u00bb{%22gcid-primary-color%22:%91%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22header_2_text_color%22%93,%22gcid-secondary-color%22:%91%22header_5_text_color%22%93}\u00bb sticky_enabled=\u00bb0″]<\/p>\n

M\u00e1s hallazgos vinculan el colesterol remanente con los resultados cardiovasculares<\/h2>\n

26 de septiembre de 2023<\/span><\/h5>\n
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Este estudio con aleatorizaci\u00f3n mendeliana que incluy\u00f3 a m\u00e1s de 900 000 participantes demostr\u00f3 una relaci\u00f3n causal gen\u00e9tica s\u00f3lida entre el colesterol remanente y los resultados cardiovasculares.<\/div>\n
Navarese EP, Vine D, Proctor S, et al. Independent causal effect of remnant cholesterol on atherosclerotic cardiovascular outcomes: a Mendelian Randomization Study. Arterioscler Thromb Vasc Biol 2023; doi: 10.1161\/ATVBAHA.123.319297.<\/em><\/div>\n
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RESUMEN DEL ESTUDIO<\/strong><\/td>\n<\/tr>\n
Objetivo:<\/strong><\/td>\nInvestigar la funci\u00f3n causal del colesterol remanente para predecir el riesgo de enfermedad de las arterias coronarias (CAD), infarto de miocardio (IM) y accidente cerebrovascular.<\/td>\n<\/tr>\n
Dise\u00f1o del estudio:<\/strong><\/td>\nEstudio con aleatorizaci\u00f3n mendeliana<\/td>\n<\/tr>\n
Poblaci\u00f3n del estudio:<\/strong><\/td>\nLos datos de una muestra combinada de 958 434 personas en el consorcio CARDIoGRAMplusC4D (Replicaci\u00f3n del Genoma Completo de la Enfermedad de las Arterias Coronarias y Metaan\u00e1lisis M\u00e1s la Gen\u00e9tica de la Enfermedad de las Arterias Coronarias), el consorcio Metastroke y el GLGC (Consorcio de la Gen\u00e9tica de los L\u00edpidos Globales).<\/td>\n<\/tr>\n
Principal variable:<\/strong><\/td>\nResultados cardiovasculares, definidos como CAD, IM y accidente cerebrovascular<\/td>\n<\/tr>\n
M\u00e9todos:<\/strong><\/td>\nEn este estudio se usaron polimorfismos de un solo nucle\u00f3tido para el colesterol remanente y el colesterol de lipoprote\u00edna de baja densidad (C-LDL) como instrumentos gen\u00e9ticos para evaluar la asociaci\u00f3n entre estos l\u00edpidos y los resultados cardiovasculares.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n
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RESULTADOS<\/strong><\/div>\n
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Hubo un efecto causal significativo del colesterol remanente en el riesgo de CAD, IM y accidente cerebrovascular sin pruebas de pleiotrop\u00eda. Por cada aumento de 1 desviaci\u00f3n est\u00e1ndar (SD) en el colesterol remanente, hab\u00eda un aumento de m\u00e1s del 50 % en el riesgo de CAD o IM, y este efecto era independiente del efecto del C-LDL.<\/p>\n

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Adem\u00e1s, el estudio demostr\u00f3 que los valores de colesterol remanente bajos durante toda la vida asociados con la inhibici\u00f3n gen\u00e9tica del colesterol remanente produc\u00edan un 40 % de reducci\u00f3n relativa del riesgo de IM.<\/p>\n

Tabla 1. Efecto en los resultados cardiovasculares por aumento en 1 SD en el colesterol remanente<\/strong><\/p>\n

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Conclusi\u00f3nes del autor:<\/strong>
Este estudio con aleatorizaci\u00f3n mendeliana a gran escala demostr\u00f3 una relaci\u00f3n causal gen\u00e9tica s\u00f3lida entre el colesterol remanente y los resultados cardiovasculares. El efecto en la CAD y el IM es independiente del colesterol LDL. El control temprano del colesterol remanente junto con la inhibici\u00f3n a largo plazo del colesterol remanente deben ser el objetivo de las intervenciones terap\u00e9uticas futuras.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
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COMENTARIO<\/strong><\/p>\n

Este estudio se suma a los datos acumulados que sustentan una relaci\u00f3n causal entre el colesterol remanente elevado, el colesterol dentro de las part\u00edculas de lipoprote\u00ednas remanentes ricas en triglic\u00e9ridos y los resultados cardiovasculares. Los datos observacionales y gen\u00e9ticos previos del Estudio de la Poblaci\u00f3n General de Copenhague y del Estudio de la Cardiopat\u00eda Isqu\u00e9mica de Copenhague demostraron que por cada 1 mmol\/l de aumento, el colesterol remanente en ausencia de ayuno estaba asociado con un aumento mayor del riesgo de resultados de enfermedad cardiovascular ateroscler\u00f3tica (ASCVD) en comparaci\u00f3n con el C-LDL (1,2). Adem\u00e1s, el colesterol remanente elevado se asoci\u00f3 con un riesgo de mortalidad mayor (3). Estos datos est\u00e1n sustentados por estudios farmacodin\u00e1micos que indicaron que el colesterol remanente cumple una funci\u00f3n importante en la aterosclerosis. El estudio actual a\u00f1ade datos s\u00f3lidos de una relaci\u00f3n causal gen\u00e9tica entre el colesterol remanente y los resultados cardiovasculares, con la asociaci\u00f3n de riesgo de IM o CAD independiente del C-LDL.<\/p>\n

Aunque los datos sustentan que el colesterol remanente es un factor de riesgo causal probable de ASCVD, persisten las incertidumbres con respecto a su medici\u00f3n y los enfoques terap\u00e9uticos (4). Por ejemplo, el colesterol remanente calculado depende de la precisi\u00f3n de la medici\u00f3n del C-LDL (5), y los an\u00e1lisis de medici\u00f3n directa de colesterol remanente requieren mayor evaluaci\u00f3n (4). Adem\u00e1s, los resultados discrepantes de ensayos recientes han engendrado confusi\u00f3n en cuanto al mejor abordaje para tratar el colesterol remanente terap\u00e9uticamente (6-8). Son necesarios m\u00e1s estudios para validar la medici\u00f3n del colesterol remanente y definir los tratamientos m\u00e1s apropiados en los pacientes de alto riesgo.<\/p>\n<\/div>\n\n\n\n\n
Referencias<\/strong><\/td>\n1. Nordestgaard BG. Triglyceride-rich lipoproteins and atherosclerotic cardiovascular disease: new insights from epidemiology, genetics, and biology. Circ Res 2016;118:547-63.
2. Varbo A, Benn M, Tybj\u00e6rg-Hansen A, J\u00f8rgensen AB, Frikke-Schmidt R, Nordestgaard BG. Remnant cholesterol as a causal risk factor for ischemic heart disease. J Am Coll Cardiol 2013; 61:427\u201336.
3. Jepsen AM, Langsted A, Varbo A, Bang LE, Kamstrup PR, Nordestgaard BG. Increased remnant cholesterol explains part of residual risk of all-cause mortality in 5414 patients with ischemic heart disease. Clin Chem 2016; 62:593\u2013604.
4. Ginsberg HN, Packard CJ, Chapman MJ, et al. Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies-a consensus statement from the European Atherosclerosis Society. Eur Heart J 2021; 42:4791\u2013806.
5. L\u00fctjohann D, Kl\u00f6r HU, Stellaard F. Measurement of serum low density lipoprotein cholesterol and triglyceride-rich remnant cholesterol as independent predictors of atherosclerotic cardiovascular disease: possibilities and limitations. Nutrients 2023;15:2202.
6. Das Pradhan A, Glynn RJ, Fruchart JC, et al. Triglyceride lowering with pemafibrate to reduce cardiovascular risk. N Engl J Med 2022; 387: 1923\u201334.
7. Bhatt DL, Steg PG, Miller M, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med 2019; 380: 11\u201322.
8. Nicholls SJ, Lincoff AM, Garcia M, et al. Effect of high-dose omega-3 fatty acids vs corn oil on major adverse cardiovascular events in patients at high cardiovascular risk: the STRENGTH randomized clinical trial. JAMA 2020; 324: 2268\u201380.<\/td>\n<\/tr>\n
Palabras claves<\/strong><\/td>\nemnant cholesterol; Mendelian randomization; atherosclerotic cardiovascular disease<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
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[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

M\u00e1s hallazgos vinculan el colesterol remanente con los resultados cardiovasculares 26 de septiembre de 2023 Este estudio con aleatorizaci\u00f3n mendeliana que incluy\u00f3 a m\u00e1s de 900 000 participantes demostr\u00f3 una relaci\u00f3n causal gen\u00e9tica s\u00f3lida entre el colesterol remanente y los resultados cardiovasculares. Navarese EP, Vine D, Proctor S, et al. Independent causal effect of remnant […]<\/p>\n","protected":false},"author":258497325,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-252756","page","type-page","status-publish","hentry"],"yoast_head":"\nHito - M\u00e1s pruebas que relacionan el colesterol remanente y los resultados cardiovasculares - R3I<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/r3i.org\/es\/hito-mas-pruebas-que-relacionan-el-colesterol-remanente-y-los-resultados-cardiovasculares\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hito - M\u00e1s pruebas que relacionan el colesterol remanente y los resultados cardiovasculares - R3I\" \/>\n<meta property=\"og:description\" content=\"M\u00e1s hallazgos vinculan el colesterol remanente con los resultados cardiovasculares 26 de septiembre de 2023 Este estudio con aleatorizaci\u00f3n mendeliana que incluy\u00f3 a m\u00e1s de 900 000 participantes demostr\u00f3 una relaci\u00f3n causal gen\u00e9tica s\u00f3lida entre el colesterol remanente y los resultados cardiovasculares. 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