{"id":252995,"date":"2025-01-21T13:36:09","date_gmt":"2025-01-21T12:36:09","guid":{"rendered":"https:\/\/r3i.org\/enfoque-r3i\/"},"modified":"2026-04-08T17:04:23","modified_gmt":"2026-04-08T15:04:23","slug":"enfoque-r3i","status":"publish","type":"page","link":"https:\/\/r3i.org\/es\/enfoque-r3i\/","title":{"rendered":"Enfoque R3i"},"content":{"rendered":"

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Enfoque R3i<\/h2>\n

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Cada a\u00f1o se publican en las principales revistas de todo el mundo m\u00e1s de 100 art\u00edculos relacionados con la dislipidemia, la hipertensi\u00f3n, la hiperglucemia, la inflamaci\u00f3n sist\u00e9mica y el estilo de vida poco saludable, as\u00ed como con los acontecimientos macrovasculares o las complicaciones microvasculares de la diabetes.<\/span>
Cada mes, R3i selecciona un art\u00edculo valioso y comenta sus aspectos m\u00e1s interesantes.<\/span><\/p>\n

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\u00daltimo enfoque<\/h2>\n

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Abordaje simult\u00e1neo de los triglic\u00e9ridos y la inflamaci\u00f3n en la prevenci\u00f3n secundaria del accidente cerebrovascular<\/h5>\n
Hoshino T, Mizuno T, Arai S, et al. Cumulative association of triglycerides and interleukin-6 with recurrent vascular events after ischemic stroke . J Clin Lipidol 2026; doi.org: 10.1016\/j.jacl.2026.01.001. <\/h6>\n

Este informe del Registro de Accidentes Cerebrovasculares de la Universidad M\u00e9dica de la Mujer de Tokio demuestra un riesgo residual de accidente cerebrovascular aditivo relacionado con la presencia simult\u00e1nea de hipertrigliceridemia e inflamaci\u00f3n.<\/p>\n

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M\u00e1s Focus<\/h2>\n

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2025 <\/span><\/h2>\n

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\u00bfUna diana nueva para reducir el riesgo cardiovascular residual en pacientes con SCA?<\/h3>\n

Kraler S, Liberale L, Tirandi A, et al. The junctional protein associated with coronary artery disease predicts adverse cardiovascular events in patients with acute coronary syndromes at high residual risk. Eur Heart J 2025; doi.org\/10.1093\/eurheartj\/ehaf979. <\/h6>\n

La prote\u00edna de uni\u00f3n asociada a la enfermedad coronaria (JCAD), que modula las v\u00edas de coagulaci\u00f3n y fibrin\u00f3lisis, puede representar un nuevo objetivo terap\u00e9utico para abordar el alto riesgo cardiovascular residual en pacientes con s\u00edndromes coronarios agudos (SCA).<\/p>\n

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Medici\u00f3n rutinaria de la hsCRP en la prevenci\u00f3n primaria.<\/h3>\n

Kurt B, Reugels M, Schneider KM, et al. C-reactive protein and cardiovascular risk in the general population. Eur Heart J 2025; doi.org\/10.1093\/eurheartj\/ehaf937 <\/h6>\n

En individuos sin enfermedad cardiovascular ateroscler\u00f3tica (ASCVD), una sola medici\u00f3n de prote\u00edna C reactiva de alta sensibilidad (hsCRP) a\u00f1adi\u00f3 valor pron\u00f3stico m\u00e1s all\u00e1 de los factores de riesgo cardiovascular tradicionales. Estos hallazgos respaldan la medici\u00f3n rutinaria de la hsCRP para mejorar la prevenci\u00f3n de la ASCVD. <\/p>\n

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\u00bfUna nueva estrategia para dirigir el objetivo terap\u00e9utico hacia ANGPTL3?<\/h3>\n

Laffin LJ, Nicholls SJ, Scott RS, et al. Phase 1 trial of CRISPR-Cas9 gene editing targeting ANGPTL3. N Engl J Med 2025; DOI: 10.1056\/NEJMoa2511778<\/h6>\n

Un ensayo de fase I mostr\u00f3 el potencial de la edici\u00f3n gen\u00e9tica de ANGPTL3, que codifica la angiopoyetina-like 3, utilizando la tecnolog\u00eda CRISPR-Cas9 en pacientes con dislipidemia refractaria.<\/p>\n

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Lipoprote\u00edna(a) elevada: un factor que aumenta el riesgo en la enfermedad arterial perif\u00e9rica.
<\/h3>\n

McClintick DJ, Biery DW, Berman AN, et al. Association between lipoprotein(a) and cardiovascular events in patients with peripheral artery disease: the Mass General Brigham Lp(a) registry. Eur J Prevent Cardiol 2025; https:\/\/doi.org\/10.1093\/eurjpc\/zwaf475<\/a><\/g> <\/h6>\n

Los hallazgos del registro Lp(a) de Mass General Brigham (MGB) muestran que la lipoprote\u00edna(a) elevada se asoci\u00f3 fuertemente tanto con eventos cardiovasculares como con eventos adversos en las extremidades inferiores.<\/p>\n

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Triglic\u00e9ridos elevados y riesgo cardiovascular residual.<\/h3>\n

Schuitema PCE, Visseren FLJ, Nordestgaard BG, et al. Elevated triglycerides are related to higher residual cardiovascular disease and mortality risk independent of lipid targets and intensity of lipid-lowering therapy in patients with established cardiovascular disease. Atherosclerosis 2025 <\/h6>\n

Los triglic\u00e9ridos elevados se asocian con un mayor riesgo cardiovascular residual, independientemente de los objetivos lip\u00eddicos y de la intensidad de la terapia hipolipemiante, seg\u00fan los hallazgos del estudio Utrecht Cardiovascular Cohort\u2013Second Manifestations of Arterial Disease (UCC-SMART). <\/em><\/p>\n

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Apolipoprote\u00edna CIII como riesgo residual: perspectivas del ensayo OPTIMAL<\/h3>\n
Kitahara S, Kataoka Y, Nicholls SJ, et al. Apolipoprotein CIII in statin-treated type 2 diabetic patients: its implications for plaque progression and instability: the pre-specified analysis from the OPTIMAL randomized controlled trial. Atherosclerosis 2025; https:\/\/doi.org\/10.1016\/j.atherosclerosis.2025.120470<\/a> <\/h6>\n

Seg\u00fan este \u00faltimo informe del ensayo OPTIMAL, la apolipoprote\u00edna CIII (ApoCIII) favoreci\u00f3 la acumulaci\u00f3n de componentes lip\u00eddicos de la placa en pacientes con diabetes tipo 2 tratados con estatinas. Estos hallazgos destacan a ApoCIII como un posible factor de riesgo residual que podr\u00eda justificar una intervenci\u00f3n terap\u00e9utica en estos pacientes de alto riesgo. <\/em><\/p>\n

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Solbinsiran, un siRNA dirigido a ANGPTL3, muestra resultados prometedores en la dislipidemia mixta.<\/h3>\n
Ray KK, Oru E, Rosenson RS, et al. Durability and efficacy of solbinsiran, a GalNAc-conjugated siRNA targeting ANGPTL3, in adults with mixed dyslipidaemia (PROLONG-ANG3): a double-blind, randomised, placebo-controlled, phase 2 trial. <\/h6>\n

En el ensayo PROLONG-ANG3, solbinsiran, un peque\u00f1o ARN interferente (siRNA) conjugado con N-acetilgalactosamina dirigido a la expresi\u00f3n hep\u00e1tica de la angiopoyetina-like protein 3 (ANGPTL3), redujo la apolipoprote\u00edna (apo)B en adultos con dislipidemia mixta. No se observ\u00f3 evidencia de efectos adversos sobre la fracci\u00f3n de grasa hep\u00e1tica. Se justifica realizar estudios adicionales. <\/p>\n

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Potencial de una terapia combinada dirigida a APOC3 y LDL-C<\/h3>\n

Wang W, Li R, Song Z, Huang N, et al. Joint associations of APOC3 and LDL-C\u2013lowering variants with the risk of coronary heart disease. <\/h6>\n

Los resultados de este estudio de asociaci\u00f3n gen\u00e9tica, que incluy\u00f3 a m\u00e1s de 400.000 sujetos del UK Biobank, proporcionan la primera evidencia de que una intervenci\u00f3n combinada dirigida a la reducci\u00f3n de APOC3 y del LDL-C podr\u00eda ofrecer mayores beneficios para los perfiles lip\u00eddicos y la reducci\u00f3n del riesgo de enfermedad coronaria en comparaci\u00f3n con la monoterapia. Estos hallazgos justifican su evaluaci\u00f3n en ensayos cl\u00ednicos. <\/p>\n

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2024 <\/span><\/h2>\n

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Centrarse en el colesterol remanente para reducir el riesgo residual de ictus<\/h3>\n

Han M, Huang K, Shen C, et al. El colesterol remanente alto discordante con el LDL-C aumenta el riesgo de ictus
: Un estudio de cohortes prospectivo chino. Ictus 2024;55:2066-74. <\/h6>\n

En este estudio prospectivo de cohortes, el colesterol remanente elevado con el colesterol de lipoprote\u00ednas de baja densidad controlado confer\u00eda un mayor riesgo de ictus, concretamente de ictus isqu\u00e9mico. Estos hallazgos apoyan el control del colesterol remanente para reducir el elevado riesgo residual de ictus isqu\u00e9mico. <\/p>\n

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El olezarsen se muestra prometedor en la hipertrigliceridemia<\/span><\/h3>\n
Bergmark BA, Marston NA, Prohaska TA, et al. Olezarsen para la hipertrigliceridemia en pacientes con alto riesgo cardiovascular. N Engl J Med 2024; DOI: 10.1056\/NEJMoa2402309<\/span><\/h6>\n

En el ensayo Bridge-TIMI 73a, el tratamiento con olezarsen, un oligonucle\u00f3tido antisentido dirigido al ARN mensajero de la apolipoprote\u00edna C-III (APOC3), redujo significativamente los triglic\u00e9ridos (TG) en pacientes con hipertrigliceridemia moderada y alto riesgo cardiovascular.<\/span><\/p>\n

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Plozasiran: un nuevo ARNsi APOC3 en la hiperlipidemia mixta<\/h3>\n

Ballantyne CM, Vasas S, Azizad M, et al. Plozasiran, un agente de interferencia de ARN dirigido a APOC3, para la hiperlipidemia mixta
. N Engl J Med 2024; doi: 10.1056\/NEJMoa2404143 <\/h6>\n

Plozasiran, una terapia de ARN interferente peque\u00f1o APOC3 dirigida por primera vez a los hepatocitos,
redujo sustancialmente los niveles de triglic\u00e9ridos en pacientes con hiperlipidemia mixta.<\/p>\n

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M\u00e1s informaci\u00f3n sobre PROMINENT<\/h3>\n

Doi T, Langsted A, Nordestgaard BG. Remnant cholesterol, LDL cholesterol, and apoB absolute mass
changes explain results of the PROMINENT trial. Atherosclerosis 2024;393:117556 <\/h6>\n

Seg\u00fan este an\u00e1lisis del Copenhagen General Population Study Group, los cambios absolutos en la masa de colesterol remanente, colesterol de lipoprote\u00ednas de baja densidad (LDL-C) y apolipoprote\u00edna (apo)B explican los resultados neutros del ensayo PROMINENT con pemafibrato.<\/p>\n

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Conclusiones del ensayo CLEAR-Outcomes: Centrarse s\u00f3lo en el colesterol LDL no es suficiente<\/span><\/h3>\n
Ridker PM, Lei L, Louie MJ, et al. Inflamaci\u00f3n y colesterol como predictores de acontecimientos cardiovasculares entre 13970 pacientes contempor\u00e1neos de alto riesgo con intolerancia a las estatinas. Circulation 2024;149:28-35. <\/span><\/h6>\n

Seg\u00fan el an\u00e1lisis de este ensayo, la prote\u00edna C reactiva de alta sensibilidad (PCR-as) predice mejor los acontecimientos cardiovasculares que el colesterol unido a lipoprote\u00ednas de baja densidad (cLDL) en los pacientes de alto riesgo intolerantes a las estatinas.<\/span><\/p>\n

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Enfermedad microvascular com\u00f3rbida en pacientes con arteriopat\u00eda perif\u00e9rica: un problema creciente<\/span><\/h3>\n
Grubman S, Algara M, Smolderen KG, et al. Examen de los resultados en pacientes ingresados con arteriopat\u00eda perif\u00e9rica y enfermedad microvascular com\u00f3rbidas. J Am Heart Assoc 2024;13:e030710.<\/span><\/h6>\n

Utilizando datos de m\u00e1s de 33 millones de ingresos hospitalarios en EE.UU., m\u00e1s del 25% de los pacientes ingresados con enfermedad arterial perif\u00e9rica (EAP) ten\u00edan enfermedad microvascular com\u00f3rbida. Este grupo presentaba un mayor riesgo de sufrir acontecimientos adversos en las extremidades y cardiovasculares. <\/span><\/p>\n

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Lipoprote\u00edna(a) elevada y riesgo coronario en pacientes con s\u00edndrome coronario agudo<\/span><\/h3>\n
Shiyovich A, Berman AN, Besser SA, et al. Resultados cardiovasculares en pacientes con enfermedad arterial coronaria y lipoprote\u00edna(a) elevada: implicaciones para la poblaci\u00f3n del ensayo OCEAN(a)-outcomes. Eur Heart J Open 2023;3, 1-4. <\/span><\/h6>\n

Este estudio observacional en pacientes con enfermedad coronaria y niveles elevados de lipoprote\u00edna(a) [Lp(a)], en consonancia con la poblaci\u00f3n incluida en el ensayo en curso Olpasiran Trials of Cardiovascular Events and Lipoprotein(a) Reduction [OCEAN(a)]-Outcomes, aporta informaci\u00f3n valiosa.<\/span><\/p>\n

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2023 <\/span><\/h2>\n

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Gesti\u00f3n del colesterol remanente: considerar tanto la acumulaci\u00f3n como la variabilidad de las visitas<\/span><\/h3>\n
Wang J, Jin R, Jin X, et al. Asociaciones separadas y conjuntas de la acumulaci\u00f3n y la variabilidad del colesterol remanente con la aterosclerosis carot\u00eddea: un estudio prospectivo de cohortes. J Am Heart Assoc 2023;12:e029352. DOI: 10.1161\/. JAHA.122.029352<\/span><\/h6>\n

Seg\u00fan este estudio de China, la combinaci\u00f3n de un mayor colesterol remanente acumulado y una mayor variabilidad del colesterol remanente agrava el riesgo independiente de aterosclerosis carot\u00eddea en la poblaci\u00f3n general.<\/span><\/p>\n

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Control lip\u00eddico en pacientes de alto riesgo: las mujeres siguen por detr\u00e1s de los hombres<\/span><\/h3>\n
Dong W, Yang Z. Tendencias en el perfil lip\u00eddico y el control lip\u00eddico entre los supervivientes de ictus o infarto de miocardio en adultos estadounidenses, 2001-2018. Front Endocrinol 2023;14:1128878<\/span><\/h6>\n

Aunque los datos de la Encuesta Nacional de Salud y Nutrici\u00f3n de EE.UU. (NHANES) 2001-2018 mostraron una tendencia a la mejora del control de los l\u00edpidos entre los supervivientes de un ictus o un infarto de miocardio (IM), las mujeres siguen teniendo un peor control de los l\u00edpidos que los hombres.<\/span><\/p>\n

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Triglic\u00e9ridos elevados, un identificador prevalente de alto riesgo cardiovascular<\/span><\/h3>\n
Leatherman S, Ferguson R, Hau C, et al. Mayor riesgo cardiovascular residual en veteranos de EE.UU. con triglic\u00e9ridos basales moderadamente elevados y niveles de LDL-C bien controlados con estatinas. Front Cardiovasc Med 2022; 9:982815. doi: 10.3389\/fcvm.2022.982815<\/span><\/h6>\n

En un gran estudio de cohortes que inclu\u00eda a casi 400.000 veteranos de EE.UU., los triglic\u00e9ridos (TG) elevados ayudaron a identificar a los individuos con enfermedad cardiovascular establecida o con diabetes sola con alto riesgo cardiovascular residual.<\/span><\/p>\n

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2022 <\/span><\/h2>\n

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RESPECT-EPA- Ensayo aleatorizado para evaluar la eficacia de la terapia combinada de estatinas y \u00e1cido eicosapentaenoico en la prevenci\u00f3n secundaria<\/span><\/h3>\n
Daida H, et al. RESPECT-EPA – Ensayo aleatorizado para evaluar la eficacia en prevenci\u00f3n secundaria de la terapia combinada: estatina y \u00e1cido eicosapentaenoico. Presentado en las Sesiones Cient\u00edficas 2022 de la Asociaci\u00f3n Americana del Coraz\u00f3n. <\/span><\/h6>\n

El ensayo RESPECT-EPA mostr\u00f3 un efecto marginalmente significativo del \u00e1cido eicosapentaenoico (EPA) altamente purificado sobre el resultado primario (un compuesto de muerte cardiovascular, infarto de miocardio [IM] no fatal, ictus isqu\u00e9mico no fatal, angina inestable o revascularizaci\u00f3n coronaria). No obstante, el estudio present\u00f3 altas tasas de abandono y de violaciones del protocolo. <\/span><\/p>\n

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Noticias de TRANSLATE-TIMI 70 con vupanorsen, oligonucle\u00f3tido antisentido ANGPLT3<\/span><\/h3>\n
Bergmark BA, Marston NA, Bramson CR, et al. Efecto del vupanorsen sobre los niveles de colesterol de lipoprote\u00ednas de no alta densidad en pacientes con colesterol elevado tratados con estatinas: TRANSLATE-TIMI 70. Circulation 2022;145:1377-1386. <\/span><\/h6>\n

En TRANSLATE-TIMI 70 (ClinicalTrials.gov Identifier: NCT04516291), el tratamiento con vupanorsen, un oligonucle\u00f3tido en antisentido que inhibe la s\u00edntesis proteica de la angiopoyetina hep\u00e1tica similar a 3 (ANGPTL3), redujo el colesterol de lipoprote\u00ednas no de alta densidad (colesterol no HDL) en pacientes tratados con estatinas. Los triglic\u00e9ridos tambi\u00e9n se redujeron de forma dependiente de la dosis.<\/span><\/p>\n

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La lipoprote\u00edna(a) elevada favorece la progresi\u00f3n de la placa vulnerable<\/span><\/h3>\n
Kaiser Y, Daghem M, Tzolos E, et al. Asociaci\u00f3n de la lipoprote\u00edna(a) con la progresi\u00f3n de la placa ateroscler\u00f3tica. J Am Coll Cardiol 2022;79:223-233. <\/span><\/h6>\n

Entre los pacientes con enfermedad coronaria avanzada, los niveles s\u00e9ricos elevados de lipoprote\u00edna(a) [Lp(a)] se asociaron con una progresi\u00f3n acelerada del n\u00facleo necr\u00f3tico de baja atenuaci\u00f3n de las placas ateroscler\u00f3ticas, evaluado mediante angiograf\u00eda por tomograf\u00eda computarizada coronaria.<\/span><\/p>\n

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Triglic\u00e9ridos y riesgo de mortalidad en la diabetes<\/span><\/h3>\n
Wadstr\u00f6m BN, Wang Y. Un mayor nivel de triglic\u00e9ridos en ayunas predice un mayor riesgo de mortalidad por diabetes en adultos estadounidenses. L\u00edpidos en la Salud y la Enfermedad 2021;20:181. <\/span><\/h6>\n

Este informe de las Encuestas Nacionales de Examen de Salud y Nutrici\u00f3n (NHANES) mostr\u00f3 que un mayor nivel de triglic\u00e9ridos en ayunas se asociaba a un mayor riesgo de muerte relacionada con la diabetes.<\/span><\/p>\n

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2021 <\/span><\/h2>\n

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Un nuevo estudio aboga por identificar el riesgo residual relacionado con el colesterol remanente en la prevenci\u00f3n primaria<\/span><\/h3>\n
Quispe R, Martin S, Michos ED et al. El colesterol remanente predice la enfermedad cardiovascular m\u00e1s all\u00e1 del LDL y la ApoB: un estudio de prevenci\u00f3n primaria. Eur Heart J 2021 doi: 10.1093\/eurheartj\/ehab432. Online antes de impresi\u00f3n. <\/span><\/h6>\n

El an\u00e1lisis de los datos agrupados de individuos libres de enfermedad cardiovascular ateroscler\u00f3tica (ECVA) mostr\u00f3 que los niveles de colesterol remanente estaban asociados a la ECVA independientemente de los factores de riesgo cardiovascular tradicionales, incluidos el colesterol de lipoprote\u00ednas de baja densidad (LDL-C), el colesterol de lipoprote\u00ednas de no alta densidad (HDL-C) o los niveles de apolipoprote\u00edna B<\/span><\/p>\n

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Estudio PESA: los triglic\u00e9ridos elevados se asocian con la aterosclerosis subcl\u00ednica<\/span><\/h3>\n
Raposeiras-Roubin S, Rossell\u00f3 X, Oliva B et al. Triglic\u00e9ridos y riesgo ateroscler\u00f3tico residual. J Am Coll Cardiol 2021;22: 3031 – 41. <\/span><\/h6>\n

En este informe del estudio PESA (Progression of Early Subclinical Atherosclerosis), los niveles de triglic\u00e9ridos (TG) \u2265150 mg\/dL (\u22651,7 mmol\/L) se asociaron con la aterosclerosis subcl\u00ednica, aunque los niveles de colesterol de lipoprote\u00ednas de baja densidad (LDL-C) fueran normales.<\/span><\/p>\n

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Colesterol remanente directo o calculado: \u00bfimporta?<\/span><\/h3>\n
Varbo A, Nordestgaard BG. El colesterol remanente medido directamente frente al calculado identifica individuos adicionales pasados por alto en la poblaci\u00f3n general con mayor riesgo de infarto de miocardio. Eur Heart J 2021 ; doi: 10.1093\/eurheartj\/ehab293. En l\u00ednea antes de impresi\u00f3n. <\/span><\/h6>\n

En este informe del Estudio de la Poblaci\u00f3n General de Copenhague, la medici\u00f3n directa del colesterol remanente identifica a un 5% adicional de individuos de la poblaci\u00f3n general con remanentes ricos en colesterol y pobres en triglic\u00e9ridos (TG) que presentan un mayor riesgo de infarto de miocardio.<\/span><\/p>\n

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Identificaci\u00f3n del riesgo cardiovascular residual: \u00bfcu\u00e1les son los mejores biomarcadores lip\u00eddicos?<\/span><\/h3>\n
Johannesen CDL, Mortensen MB, Langsted A, Nordestgaard BG. La apolipoprote\u00edna B y el colesterol no-HDL reflejan mejor el riesgo residual que el colesterol LDL en pacientes tratados con estatinas. J Am Coll Cardiol 2021;77:1439-50. <\/span><\/h6>\n

En este informe del Estudio de la Poblaci\u00f3n General de Copenhague, se prefiri\u00f3 la apolipoprote\u00edna B o el colesterol de lipoprote\u00ednas de no alta densidad (colesterol de lipoprote\u00ednas de no alta densidad) al colesterol de lipoprote\u00ednas de baja densidad (colesterol de lipoprote\u00ednas de baja densidad) para identificar mejor el riesgo cardiovascular residual en los pacientes tratados con estatinas.<\/span><\/p>\n

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PREDIMED muestra una asociaci\u00f3n entre el colesterol remanente y la enfermedad cardiovascular incidente<\/span><\/h3>\n
Casta\u00f1er O, Pint\u00f3 X, Subirana I et al. El colesterol remanente, no el colesterol LDL, se asocia con la enfermedad cardiovascular incidente. J Am Coll Cardiol 2020;76: 2712-24. <\/span><\/h6>\n

Entre los pacientes con sobrepeso u obesidad de alto riesgo en prevenci\u00f3n primaria, los niveles de triglic\u00e9ridos (TG) y colesterol remanente -pero no el colesterol de lipoprote\u00ednas de baja densidad (LDL-C)- se asocian con los resultados cardiovasculares.<\/span><\/p>\n

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La empagliflozina redujo la carga total de complicaciones cardiovasculares en pacientes con diabetes tipo 2 y enfermedad cardiovascular<\/span><\/h3>\n
McGuire DK, Zinman B, Inzucchi SE, et al. Efectos de la empagliflozina sobre los primeros acontecimientos cl\u00ednicos y los recurrentes en pacientes con diabetes tipo 2 y enfermedad cardiovascular ateroscler\u00f3tica: un an\u00e1lisis secundario del ensayo EMPA-REG OUTCOME. Lancet Diabetes Endocrinol 2020;8:949-59. <\/span><\/h6>\n

Este \u00faltimo informe del ensayo EMPA-REG OUTCOME mostr\u00f3 una agregaci\u00f3n continuada de beneficios m\u00e1s all\u00e1 de los primeros acontecimientos cardiovasculares con el inhibidor del cotransportador de sodio-glucosa-2 (SGLT2) empagliflozina, adem\u00e1s del tratamiento est\u00e1ndar actual.<\/span><\/p>\n

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2020 <\/span><\/h2>\n

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Vupanorsen, un f\u00e1rmaco antisentido ANGPTL3 conjugado con N-acetilgalactosamina, se muestra prometedor<\/span><\/h3>\n
Gaudet D, Karwatowska-Prokopczuk E, Baum SJ et al. El Vupanorsen, un f\u00e1rmaco antisentido del ARNm ANGPTL3 conjugado con N-acetilgalactosamina, reduce los triglic\u00e9ridos y las lipoprote\u00ednas aterog\u00e9nicas en pacientes con diabetes, esteatosis hep\u00e1tica e hipertrigliceridemia. Eur Heart J 2020 ; doi:10.1093\/eurheartj\/ehaa689 <\/span><\/h6>\n

El tratamiento de la s\u00edntesis proteica hep\u00e1tica de la angiopoyetina 3 (ANGPTL3) con vupanorsen (AKCEA-ANGPTL3-L Rx) redujo los triglic\u00e9ridos en ayunas y las lipoprote\u00ednas aterog\u00e9nicas que contienen apolipoprote\u00edna B en pacientes con diabetes tipo 2, esteatosis hep\u00e1tica y triglic\u00e9ridos elevados.<\/span><\/p>\n

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Lipoprote\u00edna(a): un marcador de riesgo cardiovascular residual<\/span><\/h3>\n
La lipoprote\u00edna(a) puede ofrecer valor pron\u00f3stico al evaluar el riesgo de eventos cardiovasculares recurrentes, seg\u00fan este an\u00e1lisis de pacientes en prevenci\u00f3n secundaria realizado en el mundo real.<\/span><\/h6>\n

Liu HH, Cao YX, Jin JL et al. Asociaci\u00f3n de los niveles de lipoprote\u00edna(a) con los acontecimientos recurrentes en pacientes con enfermedad arterial coronaria. Heart 2020; doi:10.1136\/heartjnl-2020-316586.<\/span><\/p>\n

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Conclusiones del Estudio sobre la Salud de la Mujer: El colesterol en las lipoprote\u00ednas ricas en triglic\u00e9ridos se asocia fuertemente con la enfermedad cardiovascular incidente<\/span><\/h3>\n
Los resultados de un estudio prospectivo de cohortes de casos dentro del Women’s Health Study muestran que el contenido de colesterol de las lipoprote\u00ednas ricas en triglic\u00e9ridos (TRL) influye en la aterog\u00e9nesis independientemente del colesterol de las lipoprote\u00ednas de baja densidad.<\/span><\/h6>\n

Duran EK, Aday AW, Cook NR et al. Colesterol de lipoprote\u00ednas rico en triglic\u00e9ridos, colesterol LDL denso peque\u00f1o y enfermedad cardiovascular incidente. J Am Coll Cardiol 2020; 75:2122-35. <\/span><\/p>\n

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Metaan\u00e1lisis: Asociaci\u00f3n entre la disminuci\u00f3n de los triglic\u00e9ridos y la reducci\u00f3n del riesgo cardiovascular<\/span><\/h3>\n
En los ensayos controlados aleatorizados, la reducci\u00f3n de los triglic\u00e9ridos se asocia a un menor riesgo de acontecimientos vasculares importantes, incluso tras el ajuste por la reducci\u00f3n del colesterol de lipoprote\u00ednas de baja densidad (LDL-C).<\/span><\/h6>\n

Marston NA, Giugliano RP, Im KA, et al. Asociaci\u00f3n entre la disminuci\u00f3n de los triglic\u00e9ridos y la reducci\u00f3n del riesgo cardiovascular en m\u00faltiples clases terap\u00e9uticas hipolipemiantes. Una revisi\u00f3n sistem\u00e1tica y un an\u00e1lisis de metarregresi\u00f3n de ensayos controlados aleatorizados. Circulation 2019;140:1308-17. <\/span><\/p>\n

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Datos del mundo real: La hipertrigliceridemia es frecuente entre los pacientes con enfermedades cardiovasculares y confiere un mayor riesgo cardiovascular<\/span><\/h3>\n
Uno de cada cuatro pacientes con enfermedad cardiovascular y colesterol unido a lipoprote\u00ednas de baja densidad controlado tiene niveles elevados de triglic\u00e9ridos (135-499 mg\/dL o 1,52-5,63 mmol\/L). El riesgo de acontecimientos cardiovasculares en este grupo aumenta a medida que aumentan los niveles de triglic\u00e9ridos. <\/span><\/h6>\n

Lawler PR, Kotrri G, Koh M et al. Riesgo real de resultados cardiovasculares asociados a la hipertrigliceridemia entre individuos con enfermedad cardiovascular ateroscler\u00f3tica y elegibilidad potencial para terapias emergentes. Eur Heart J 2019; doi:10.1093\/eurheartj\/ehz767 <\/span><\/p>\n

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2019 <\/span><\/h2>\n

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Anticuerpo monoclonal ANGPTL3 en la hipertrigliceridemia<\/span><\/h3>\n
El evinacumab, un anticuerpo monoclonal contra la ANGPTL3 (prote\u00edna 3 similar a la angiopoyetina), produjo una reducci\u00f3n sustancial y sostenida de los triglic\u00e9ridos en ensayos de fase I en pacientes con hipertrigliceridemia de leve a moderada.<\/span><\/h6>\n

Ahmad Z, Banerjee P, Hamon S et al. La inhibici\u00f3n de la prote\u00edna 3 similar a la angiopoyetina con un anticuerpo monoclonal reduce los triglic\u00e9ridos en la hipertrigliceridemia. Circulation 2019; DOI: 10.1161\/CIRCULATIONAHA.118.039107 <\/span><\/p>\n

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Colesterol remanente y riesgo de ictus isqu\u00e9mico<\/span><\/h3>\n
Los niveles elevados de colesterol remanente se asociaron a un mayor riesgo de ictus isqu\u00e9mico, seg\u00fan este informe del Estudio de la Poblaci\u00f3n General de Copenhague.<\/span><\/h6>\n

Varbo A, Nordestgaard BG. Colesterol remanente y riesgo de ictus isqu\u00e9mico en 112.512 individuos de la poblaci\u00f3n general. Ann Neurol 2019;85:550-9. <\/span><\/p>\n

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2018 <\/span><\/h2>\n

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M\u00e1s pruebas que relacionan los restos con las enfermedades cardiovasculares<\/span><\/h3>\n
Los resultados del estudio ARIC (Atherosclerosis Risk in Communities) muestran que tanto los niveles de colesterol de lipoprote\u00ednas remanentes (RLP-C) como los de triglic\u00e9ridos de lipoprote\u00ednas de baja densidad (LDL-TG) eran predictivos de la enfermedad cardiovascular y estaban asociados a las variantes APOE.<\/span><\/h6>\n

Saeed A, Feofanova EV, Yu B et al. Colesterol de part\u00edculas remanentes, triglic\u00e9ridos de lipoprote\u00ednas de baja densidad y enfermedad cardiovascular incidente. J Am Coll Cardiol 2018;72:156-69. <\/span><\/p>\n

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Enfoque R3iCada a\u00f1o se publican en las principales revistas de todo el mundo m\u00e1s de 100 art\u00edculos relacionados con la dislipidemia, la hipertensi\u00f3n, la hiperglucemia, la inflamaci\u00f3n sist\u00e9mica y el estilo de vida poco saludable, as\u00ed como con los acontecimientos macrovasculares o las complicaciones microvasculares de la diabetes.Cada mes, R3i selecciona un art\u00edculo valioso y […]<\/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":"","_crdt_document":"","footnotes":""},"class_list":["post-252995","page","type-page","status-publish","hentry"],"yoast_head":"\nR3i Focus: Res\u00famenes expertos de ensayos cl\u00ednicos<\/title>\n<meta name=\"description\" content=\"Los informes R3i Focus resumen los principales ensayos cl\u00ednicos y la evidencia emergente sobre el riesgo 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