{"id":252998,"date":"2025-01-21T13:16:40","date_gmt":"2025-01-21T12:16:40","guid":{"rendered":"https:\/\/r3i.org\/hitos-de-r3i\/"},"modified":"2026-04-08T17:33:27","modified_gmt":"2026-04-08T15:33:27","slug":"hitos-de-r3i","status":"publish","type":"page","link":"https:\/\/r3i.org\/es\/hitos-de-r3i\/","title":{"rendered":"Hitos de R3i"},"content":{"rendered":"

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Hitos de R3i<\/h2>\n

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En los \u00faltimos 15 a\u00f1os, grandes ensayos cl\u00ednicos han demostrado que, aunque el tratamiento con estatinas reduce los principales acontecimientos cardiovasculares en un 25-35%, sigue existiendo un riesgo cardiovascular residual considerable. Adem\u00e1s, las terapias multifactoriales agresivas en la diabetes tipo 2 no consiguen prevenir totalmente las complicaciones microvasculares. Esta secci\u00f3n examina estos hallazgos, abordando los riesgos residuales macro y microvasculares. <\/p>\n

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\u00daltimos hitos<\/h2>\n

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Lo nuevo sobre REDUCE-IT: El tratamiento con etilo de icosapento reduce la carga total de la enfermedad<\/h5>\n
Febrero de 2026<\/h6>\n

En este an\u00e1lisis m\u00e1s reciente, el tratamiento con etilo de icosapento redujo las hospitalizaciones y la duraci\u00f3n de las hospitalizaciones en personas con riesgo cardiovascular alto, lo que implica tanto beneficios cl\u00ednicos como beneficios para los pacientes.
Szarek M, Bhatt DL, Miller M, et al. Effects of icosapent ethyl on risk and duration of hospitalizations and death in REDUCE-IT. Eur J Prev Cardiol 2026: doi: 10.1093\/eurjpc\/zwag040. <\/em><\/p>\n

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M\u00e1s monumentos<\/h2>\n

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

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Reflexiones sobre FOURIER: riesgo cardiovascular asociado con la obesidad<\/h5>\n
Deciembre 2025<\/h6>\n

El tratamiento con evolocumab redujo el riesgo cardiovascular en personas obesas con enfermedad cardiovascular ateroscler\u00f3tica.
Kang YM, Giugliano RP, Keech AC, et al. Obesity-associated cardiovascular risk and benefit from PCSK9 inhibition. A prespecified analysis from FOURIER. J Am Coll Cardiol 2025; doi.org\/10.1016\/j.jacc.2025.10.036. <\/p>\n

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VESALIUS-CV: A\u00f1adir evolocumab al tratamiento hipolipemiante est\u00e1ndar previene un primer acontecimiento cardiovascular grave en pacientes de alto riesgo<\/h5>\n
Noviembre 2025<\/h6>\n

La combinaci\u00f3n del inhibidor de PCKS9 evolocumab con la terapia hipolipemiante est\u00e1ndar redujo los primeros acontecimientos cardiovasculares importantes en un 25% en adultos de alto riesgo cardiovascular (evidencia de aterosclerosis o con diabetes de alto riesgo) y sin antecedentes de infarto de miocardio o ictus. <\/em><\/p>\n

Bohula EA, Marston NA, Bhatia AK, et al. Evolocumab in patients without a previous myocardial Infarction or stroke. N Engl J Med 2025; DOI: 10.1056\/NEJMoa2514428. <\/em><\/p>\n

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Objetivo lipoprote\u00edna(a) elevada en pacientes con s\u00edndromes coronarios agudos<\/h5>\n
Octubre de 2025<\/h6>\n

Los pacientes con s\u00edndromes coronarios agudos y lipoprote\u00edna(a) elevada obtienen una reducci\u00f3n m\u00e1s temprana y mayor del riesgo tanto de acontecimientos cardiovasculares adversos importantes como de acontecimientos adversos en las extremidades con alirocumab: conclusiones de ODYSSEY OUTCOMES.
Ray KK, Szarek M, Bhatt DL, et al. Lipoprotein(a) identifies patients with acute coronary syndromes who derive cardiovascular benefit from alirocumab, particularly for limb events. J Am Coll Cardiol 2025; https:\/\/doi.org\/10.1016\/j.jacc.2025.08.043<\/a> <\/p>\n

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El ensayo STRENGTH sugiere beneficios en pacientes asi\u00e1ticos<\/h5>\n
Septiembre de 2025<\/h6>\n

Un an\u00e1lisis exploratorio del ensayo neutral STRENGTH indica que el tratamiento con una formulaci\u00f3n de \u00e1cidos carbox\u00edlicos omega-3 (\u03c9-3) se asoci\u00f3 a una reducci\u00f3n significativa de los principales acontecimientos cardiovasculares adversos en pacientes asi\u00e1ticos, pero no en pacientes no asi\u00e1ticos con alto riesgo cardiovascular.<\/em><\/p>\n

Wang TKM, Nicholls SJ, St John J, et al. Differential cardiovascular impact of \u03c9-3 fatty acid in patients at high cardiovascular risk in Asians versus non-Asians: Sub-analysis of the STRENGTH randomized clinical trial. Atherosclerosis 2025; <\/em> <\/span>https:\/\/doi.org\/10.1016\/j.atherosclerosis.2025.120228<\/a>.<\/em><\/p>\n

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REDUCE-LO: El Icosapent et\u00edlico reduce el riesgo cardiovascular incluso con un LDL-C bajo<\/h5>\n
August 2025<\/h6>\n

En este an\u00e1lisis de REDUCE-IT, las dosis altas de icosapent etilo redujeron los episodios cardiovasculares en un 34% entre los pacientes de alto riesgo cardiovascular con triglic\u00e9ridos elevados, incluso entre los que ten\u00edan niveles de colesterol de lipoprote\u00ednas de baja densidad por debajo de los objetivos recomendados por las directrices.<\/p>\n

Aggarwal R, Bhatt DL, Steg PG, et al. Cardiovascular outcomes with icosapent ethyl by baseline low-density lipoprotein cholesterol: a secondary analysis of the REDUCE-IT randomized trial. J Am Heart Assoc. 2025;14(5):e038656. <\/em><\/p>\n

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M\u00e1s datos del ensayo LoDoCo2 (Dosis bajas de colchicina 2)<\/h5>\n
Julio de 2025<\/h6>\n

Este \u00faltimo an\u00e1lisis<\/span><\/i> respalda el uso de colchicina en pacientes con s\u00edndrome coronario cr\u00f3nico en todo el espectro de riesgo basal. <\/span><\/i> <\/p>\n

Mohammadnia N, Wesselink BE, Bax WA, et al. Cardiovascular benefit of colchicine in relation to baseline risk: a secondary analysis of the LoDoCo2 Trial. J Am Heart Assoc 2025;14:e038687. DOI: 10.1161\/JAHA.124.038687. <\/span><\/i><\/p>\n

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Se necesitan medidas inmediatas para hacer frente a la obesidad mundial en ni\u00f1os y adolescentes<\/h5>\n
Abril 2025<\/h6>\n

Los \u00faltimos datos del Estudio sobre la Carga Mundial de Morbilidad 2021 ponen de manifiesto una epidemia mundial de obesidad en ni\u00f1os y adolescentes. Los datos de las previsiones indican que alrededor de un tercio de los ni\u00f1os y adolescentes tendr\u00e1n sobrepeso o ser\u00e1n obesos en 2050, a menos que se tomen medidas urgentes e inmediatas ahora. <\/span><\/i><\/p>\n

GBD 2021 Adolescent BMI Collaborators. Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990\u20132021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021. Lancet 2025; 405: 785\u2013812 <\/span><\/i><\/p>\n

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

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Conclusiones de PROMINENT: El pemafibrato reduce el riesgo de \u00falcera o gangrena en pacientes con diabetes tipo 2<\/h3>\n

Agosto de 2024<\/span><\/h6>\n
\n

Estos resultados del ensayo PROMINENT sugieren que el pemafibrato puede ofrecer potencial terap\u00e9utico
para reducir la ulceraci\u00f3n isqu\u00e9mica de las extremidades inferiores y la gangrena en pacientes con diabetes de tipo 2.<\/p>\n

Marinho LL, Everett BM, Aday AW, et al. Effect of pemafibrate on diabetic foot ulceration and
gangrene. An exploratory analysis from PROMINENT. J Am Coll Cardiol 2024;84:408-410. <\/p>\n<\/div>\n

[\/et_pb_text][et_pb_button button_url=\u00bb@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjI1MjA5MSIsImVuYWJsZV9odG1sIjoib2ZmIn19@\u00bb url_new_window=\u00bbon\u00bb button_text=\u00bbSigue leyendo\u00bb button_alignment=\u00bbright\u00bb _builder_version=\u00bb4.27.4″ _dynamic_attributes=\u00bbbutton_url\u00bb _module_preset=\u00bb9bc3f405-43a0-4056-a483-11952257355c\u00bb button_bg_color=\u00bbRGBA(255,255,255,0)\u00bb button_icon=\u00bb$||divi||400″ button_icon_color=\u00bbgcid-primary-color\u00bb button_on_hover=\u00bboff\u00bb custom_margin=\u00bb|44px|||false|false\u00bb global_colors_info=\u00bb{%22gcid-primary-color%22:%91%22button_text_color%22,%22button_icon_color%22%93}\u00bb][\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb4.27.4″ _module_preset=\u00bbdefault\u00bb background_color=\u00bbgcid-b673dc17-1b2a-464e-affa-1bf1ab41c0fd\u00bb custom_margin=\u00bb20px||||false|false\u00bb custom_padding=\u00bb||0px|||\u00bb border_radii=\u00bbon|20px|20px|20px|20px\u00bb global_colors_info=\u00bb{%22gcid-b673dc17-1b2a-464e-affa-1bf1ab41c0fd%22:%91%22background_color%22%93}\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_3_text_color=\u00bbgcid-4907c8d4-9eff-49de-91ce-43a2d3a729cf\u00bb header_6_text_color=\u00bbgcid-secondary-color\u00bb custom_margin=\u00bb||-12px|||\u00bb custom_padding=\u00bb|28px||28px|false|false\u00bb link_option_url_new_window=\u00bbon\u00bb global_colors_info=\u00bb{%22gcid-primary-color%22:%91%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22%93,%22gcid-4907c8d4-9eff-49de-91ce-43a2d3a729cf%22:%91%22header_3_text_color%22%93,%22gcid-secondary-color%22:%91%22header_6_text_color%22%93}\u00bb]<\/p>\n

REDUCE-IT: Icosapent et\u00edlico en el s\u00edndrome coronario agudo<\/h3>\n

Julio de 2024<\/span><\/h6>\n
Seg\u00fan este an\u00e1lisis post hoc del ensayo REDUCE-IT (Reduction of Cardiovascular Events with
Icosapent Ethyl-Intervention Trial), el tratamiento con icosapent et\u00edlico redujo el riesgo de acontecimientos isqu\u00e9micos
en pacientes de alto riesgo, tratados con estatinas y con un s\u00edndrome coronario agudo reciente (<12 meses)
(SCA), sin exceso de hemorragias.
Sayah N, Bhatt DL, Miller M, et al. Icosapent et\u00edlico tras un s\u00edndrome coronario agudo: el estudio REDUCE-IT <\/em>
ensayo. Eur Heart J 2024;45: 1173-76. <\/em><\/div>\n

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M\u00e1s de REDUCE-IT: \u00bfModifica la lipoprote\u00edna(a) la reducci\u00f3n del riesgo con icosapent et\u00edlico?<\/span><\/h3>\n
27 de junio de 2024<\/span><\/h6>\n
En este an\u00e1lisis post hoc del ensayo REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial), el icosapent etil redujo sistem\u00e1ticamente el riesgo de acontecimientos cardiovasculares adversos mayores (MACE) en toda la gama de niveles de lipoprote\u00edna(a) [Lp(a)], incluso entre los pacientes con niveles elevados de Lp(a) cl\u00ednicamente relevantes.<\/div>\n
Szarek M, Bhatt DL, Miller M, et al. Niveles sangu\u00edneos de lipoprote\u00edna(a) y reducci\u00f3n del riesgo cardiovascular con icosapent etil. J Am Coll Cardiol 2024; 83:1529-39. <\/em><\/div>\n

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REDUCE-LO: Mayor riesgo mayor beneficio del icosapent et\u00edlico<\/h3>\n

Mayo de 2024<\/span><\/h6>\n
En este \u00faltimo an\u00e1lisis de REDUCE-IT (Ensayo de Reducci\u00f3n de los Acontecimientos Cardiovasculares con Icosapent
Etil-Intervenci\u00f3n), el icosapent etil redujo sistem\u00e1ticamente el riesgo de acontecimientos cardiovasculares adversos mayores
(MACE) en pacientes con enfermedad cardiovascular ateroscler\u00f3tica (ECVA) y
triglic\u00e9ridos elevados en toda la gama de riesgo residual basal. Sin embargo, los efectos absolutos del tratamiento
fueron mayores en los pacientes con mayor riesgo residual al inicio del estudio.
Burger PM, Bhatt DL, Dorresteijn JAN, et al. Efectos del icosapent et\u00edlico seg\u00fan la l\u00ednea de base residual <\/em>
riesgo en pacientes con enfermedad cardiovascular ateroscler\u00f3tica: resultados de REDUCE-IT. Eur Heart J <\/em>
Cardiovasc Pharmacother 2024; doi: 10.1093\/ehjcvp\/pvae030.<\/em><\/div>\n

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Colesterol no-HDL: un marcador accesible de alto riesgo residual<\/span><\/h3>\n
20 de mayo de 2024<\/span><\/h6>\n
\n
Este estudio, que incluye a m\u00e1s de 23.000 pacientes tratados con estatinas, con cardiopat\u00eda isqu\u00e9mica y niveles de colesterol unido a lipoprote\u00ednas de baja densidad (LDL-C) bien controlados, confirma que el colesterol unido a lipoprote\u00ednas de no alta densidad (no HDL-C) es una medida sencilla y s\u00f3lida para identificar a los pacientes que tienen un riesgo residual elevado.<\/div>\n
Hansen MK, Mortensen MB, Warnakula Olesen KK, et al. Colesterol no-HDL y riesgo residual de acontecimientos cardiovasculares en pacientes con cardiopat\u00eda isqu\u00e9mica y colesterol LDL bien controlado: un estudio de cohortes. The Lancet Regional Health – Europe 2024;36: 100774. <\/em><\/div>\n<\/div>\n

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Primer ensayo en humanos de un nuevo ARNsi para reducir la lipoprote\u00edna(a)<\/span><\/h3>\n
12 de marzo de 2024<\/span><\/h6>\n
\n
\n
El lepodisiran, un nuevo ARN de interferencia corta (ARNsi), redujo la concentraci\u00f3n de lipoprote\u00edna(a) [Lp(a)] en un 97% en la dosis \u00fanica m\u00e1s alta, con una respuesta sostenida a largo plazo.<\/div>\n
Nissen SE, Linnebjerg H, Shen X, et al. Lepodisiran, un ARN de interferencia corta de duraci\u00f3n prolongada dirigido a la lipoprote\u00edna(a): un ensayo cl\u00ednico aleatorizado de dosis ascendente. JAMA 2023;330:2075-83. <\/em><\/div>\n<\/div>\n<\/div>\n

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Primeros datos con muvalaplin, una peque\u00f1a mol\u00e9cula oral inhibidora de la formaci\u00f3n de lipoprote\u00edna(a)<\/span><\/h3>\n
8 de enero de 2024<\/span><\/h6>\n
\n
\n
\n
En este ensayo de fase I, la muvalaplina redujo los niveles de lipoprote\u00edna(a) [Lp(a)] hasta en un 65% sin ning\u00fan problema de seguridad, lo que proporciona una base para un mayor desarrollo cl\u00ednico.<\/div>\n
Nicholls SJ, Nissen SE, Fleming C, et al. Muvalaplin, un inhibidor oral de mol\u00e9cula peque\u00f1a de la formaci\u00f3n de lipoprote\u00edna(a): un ensayo cl\u00ednico aleatorizado. JAMA 2023;e2316503. doi: 10.1001\/jama.2023.16503. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n

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

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M\u00e1s pruebas que relacionan el colesterol remanente y los resultados cardiovasculares<\/span><\/h3>\n
26 de septiembre de 2023<\/span><\/h6>\n
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Este estudio de aleatorizaci\u00f3n mendeliana, que incluy\u00f3 a m\u00e1s de 900.000 sujetos, mostr\u00f3 una s\u00f3lida asociaci\u00f3n causal gen\u00e9tica entre el colesterol remanente y los resultados cardiovasculares.<\/div>\n
Navarese EP, Vine D, Proctor S, et al. Efecto causal independiente del colesterol remanente en los resultados cardiovasculares ateroscler\u00f3ticos: un estudio de aleatorizaci\u00f3n mendeliana. Arterioscler Thromb Vasc Biol 2023; doi: 10.1161\/ATVBAHA.123.319297. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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RESULTADOS DE CLEAR (Reducci\u00f3n del colesterol mediante \u00e1cido bempedoico [ECT1002], un r\u00e9gimen inhibidor del LCA): papel del \u00e1cido bempedoico en pacientes de alto riesgo intolerantes a las estatinas<\/span><\/h3>\n
6 de julio de 2023<\/h6>\n
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La reducci\u00f3n del colesterol de lipoprote\u00ednas de baja densidad (LDL-C) con \u00e1cido bempedoico redujo los principales acontecimientos cardiovasculares adversos en pacientes de alto riesgo incapaces de tolerar el tratamiento con estatinas.<\/div>\n
Nissen SE, Lincoff AM, Brennan D et al. El \u00e1cido bempedoico y los resultados cardiovasculares en pacientes intolerantes a las estatinas. N Engl J Med 2023; DOI: 10.1056\/NEJMoa2215024 <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Ensayo EMPA-KIDNEY (Estudio de Protecci\u00f3n Card\u00edaca y Renal con Empagliflozina): La empagliflozina muestra beneficios renales y cardiovasculares en pacientes con enfermedad renal cr\u00f3nica<\/span><\/h3>\n
13 de abril de 2023<\/span><\/h6>\n
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En pacientes con enfermedad renal cr\u00f3nica (ERC) en riesgo de progresi\u00f3n de la enfermedad, el tratamiento con empagliflozina se asoci\u00f3 a un menor riesgo de progresi\u00f3n de la enfermedad renal o de muerte por causas cardiovasculares que el placebo.<\/div>\n
Grupo Colaborador EMPA-KIDNEY; Herrington WG, Staplin N, Wanner C, et al. Empagliflozina en pacientes con enfermedad renal cr\u00f3nica. N Engl J Med 2022; doi: 10.1056\/NEJMoa2204233. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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

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Resultados de PROMINENT<\/span><\/h3>\n
6 de diciembre de 2022<\/span><\/h6>\n
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En el estudio PROMINENT (Pemafibrate to Reduce Cardiovascular OutcoMes by Reducing Triglycerides IN patiENts With diabetes), la reducci\u00f3n de los niveles de triglic\u00e9ridos en un 26% con pemafibrato, adem\u00e1s del tratamiento intenso con estatinas, no redujo significativamente los acontecimientos cardiovasculares en pacientes con diabetes tipo 2 e hipertrigliceridemia. Sin embargo, los datos exploratorios sugieren que este tratamiento puede tener potencial en la enfermedad del h\u00edgado graso no alcoh\u00f3lico (HGNA). <\/div>\n
Pradhan AD, Glynn RJ, Fruchart JC, et al. Disminuci\u00f3n de los triglic\u00e9ridos con pemafibrato para reducir el riesgo cardiovascular. New Engl J Med 2022; DOI: 10.1056\/NEJMoa2210645 <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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RESULTADOS DE LA ODISEA: La apolipoprote\u00edna B proporciona informaci\u00f3n incremental sobre el riesgo cardiovascular residual<\/span><\/h3>\n
21 de septiembre de 2022<\/span><\/h6>\n
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Un nuevo an\u00e1lisis del ensayo ODYSSEY OUTCOMES (Evaluaci\u00f3n de los Resultados Cardiovasculares Tras un S\u00edndrome Coronario Agudo Durante el Tratamiento con Alirocumab) respalda el uso de la apolipoprote\u00edna B (apoB) como gu\u00eda para el uso de la reducci\u00f3n intensiva incremental de las lipoprote\u00ednas aterog\u00e9nicas en pacientes con un s\u00edndrome coronario agudo (SCA) en tratamiento con estatinas.<\/span><\/div>\n
Hagstr\u00f6m E, Steg PG, Szarek M, et al. Apolipoprote\u00edna B, riesgo cardiovascular residual tras s\u00edndrome coronario agudo y efectos del alirocumab. Circulation 2022 Jun 30:101161CIRCULATIONAHA121057807. doi: 10.1161\/CIRCULATIONAHA.121.057807. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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El ensayo EMPA-KIDNEY se interrumpi\u00f3 antes de tiempo debido a la evidencia de eficacia<\/span><\/h3>\n
19 de julio de 2022<\/span><\/h6>\n
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EMPA-KIDNEY (ClinicalTrials.gov Identifier: NCT03594110) estaba probando si la empagliflozina, un inhibidor del cotransportador de sodio-glucosa-2 (SGLT-2), previene la progresi\u00f3n de la enfermedad renal o la muerte cardiovascular en pacientes con enfermedad renal cr\u00f3nica (ERC). El ensayo se interrumpi\u00f3 el 16 de marzo por recomendaci\u00f3n del Comit\u00e9 Independiente de Supervisi\u00f3n de Datos debido a la evidencia de que la empagliflozina es m\u00e1s eficaz que el placebo. <\/span><\/div>\n
EMPA-RENAL. https:\/\/www.empakidney.org\/news\/empa-kidney-trial-stops-early-due-to-evidence-of-efficacy<\/a>.<\/em><\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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

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Un nuevo metaan\u00e1lisis reafirma el beneficio favorable frente al riesgo de los agonistas del receptor de GLP-1 en pacientes con diabetes mellitus tipo 2<\/span><\/h3>\n
2 de noviembre de 2021<\/span><\/h6>\n
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Este \u00faltimo informe, que incluye datos de m\u00e1s de 60.000 pacientes con diabetes mellitus tipo 2 (DMT2), demostr\u00f3 que los agonistas del receptor del P\u00e9ptido similar al glucag\u00f3n-1 (GLP-1) reducen el riesgo de acontecimientos cardiovasculares, la mortalidad por cualquier causa, el ingreso hospitalario por insuficiencia cardiaca y el empeoramiento de la funci\u00f3n renal.<\/span><\/div>\n
Sattar N, Lee MMY, Kristensen SL, et al. Resultados cardiovasculares, de mortalidad y renales con agonistas del receptor de GLP-1 en pacientes con diabetes tipo 2: revisi\u00f3n sistem\u00e1tica y metaan\u00e1lisis de ensayos aleatorizados. Lancet Diabetes Endocrinol 2021; doi: 10.1016\/S2213-8587(21)00203-5. En l\u00ednea antes de impresi\u00f3n. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Desentra\u00f1ar las razones de la falta de beneficios cardiovasculares en STRENGTH<\/span><\/h3>\n
7 de septiembre de 2021<\/span><\/h6>\n
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Un nuevo an\u00e1lisis de STRENGTH no muestra ninguna asociaci\u00f3n entre los niveles alcanzados de \u00e1cido eicosapentaenoico (EPA) y \u00e1cido docosahexaenoico (DHA) y los principales resultados cardiovasculares.<\/span><\/div>\n
Nissen SE, Lincoff AM, Wolski K, et al. Asociaci\u00f3n entre los niveles alcanzados de \u00e1cidos grasos \u03c9-3 y los principales resultados cardiovasculares adversos en pacientes con alto riesgo cardiovascular. Un an\u00e1lisis secundario del ensayo STRENGTH. JAMA Cardiol 2021; doi:10.1001\/jamacardio.2021.1157 <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Noticias de REDUCE-IT: El icosapent et\u00edlico reduce el riesgo de ictus isqu\u00e9mico<\/span><\/h3>\n
9 de agosto de 2021<\/span><\/h6>\n
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Un nuevo an\u00e1lisis de REDUCE-IT muestra que el tratamiento con icosapent et\u00edlico reduce el riesgo de un primer ictus isqu\u00e9mico en un 36%.<\/span><\/div>\n
Bhatt DL, Steg PG, Miller M, et al. Reducci\u00f3n del ictus isqu\u00e9mico con icosapento etilo: conclusiones de REDUCE-IT. Ictus 2021; 52 (Suppl_1). CONFERENCIA INTERNACIONAL SOBRE EL ICTUS 2021 RES\u00daMENES ORALES <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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RESULTADOS DE LA ODISEA: \u00bfLa inhibici\u00f3n de la PCSK9 aumenta el riesgo de diabetes?<\/span><\/h3>\n
21 de mayo de 2021<\/span><\/h6>\n
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La elevaci\u00f3n de la lipoprote\u00edna(a) [Lp(a)] se considera un factor de riesgo cardiovascular, atribuido a sus propiedades aterog\u00e9nicas, proinflamatorias y protromb\u00f3ticas. Los estudios observacionales tambi\u00e9n sugieren que los niveles bajos de Lp(a) se asocian a un mayor riesgo de diabetes incidente (de nueva aparici\u00f3n). Sigue siendo controvertido si los agentes farmacol\u00f3gicos que reducen la Lp(a) tambi\u00e9n aumentan este riesgo. Abordando esta cuesti\u00f3n, este an\u00e1lisis de ODYSSEY OUTCOMES sugiere que los pacientes con la mayor reducci\u00f3n de los niveles de Lp(a) pueden tener un riesgo ligeramente mayor de desarrollar diabetes de tipo 2. Sin embargo, es probable que este riesgo se vea superado con creces por la reducci\u00f3n del riesgo cardiovascular residual observada en el ensayo. <\/span><\/div>\n
Schwartz GG, Szarek M, Bittner VA et al. Relaci\u00f3n de los niveles de lipoprote\u00edna(a) con la diabetes tipo 2 incidente y modificaci\u00f3n por el tratamiento con alirocumab. Diabetes Care 2021; https:\/\/care.diabetesjournals.org\/content\/early\/2021\/03\/10\/dc20-2842<\/a> <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Resultados CLEAR: Evaluaci\u00f3n de Acontecimientos Cardiovasculares Mayores en Pacientes con Enfermedad Cardiovascular o Alto Riesgo de Padecerla, Intolerantes a las Estatinas Tratados con \u00c1cido Bempedoico (ETC-1002) o Placebo<\/span><\/h3>\n
26 de abril de 2021<\/span><\/h6>\n
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CLEAR Outcomes reclut\u00f3 espec\u00edficamente a pacientes de alto riesgo con intolerancia documentada a las estatinas y niveles elevados de colesterol de lipoprote\u00ednas de baja densidad (LDL-C) que siguen teniendo un riesgo cardiovascular residual elevado.<\/span><\/div>\n
Nicholls SJ, Lincoff AM, Bays HE et al. Justificaci\u00f3n y dise\u00f1o del ensayo CLEAR-outcomes: Evaluaci\u00f3n del efecto del \u00e1cido bempedoico sobre los eventos cardiovasculares en pacientes con intolerancia a las estatinas. Am Heart J 2020;235:104-112. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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El Estudio Internacional Polycap-3 (TIPS-3) demostr\u00f3 que la combinaci\u00f3n de una polip\u00edldora y aspirina reduc\u00eda los acontecimientos cardiovasculares en pacientes en prevenci\u00f3n primaria<\/span><\/h3>\n
22 de marzo de 2021<\/span><\/h6>\n
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El tratamiento con una polip\u00edldora dirigida al colesterol elevado de lipoprote\u00ednas de baja densidad y a la hipertensi\u00f3n arterial, junto con aspirina, redujo los acontecimientos cardiovasculares en un 31% en individuos de riesgo intermedio sin enfermedad cardiovascular preexistente.<\/span><\/div>\n
Yusuf S, Joseph P, Dans A, et al. Polip\u00edldora con o sin aspirina en personas sin enfermedad cardiovascular. N Engl J Med 2021; 384:216-228. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Ensayo de Reducci\u00f3n de los Acontecimientos Cardiovasculares con Icosapent Etil’\u00c4\u00ec-Intervenci\u00f3n (REDUCE-IT) REVASC<\/span><\/h3>\n
16 de febrero de 2021<\/span><\/h6>\n
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Los \u00faltimos datos de REDUCE-IT muestran que el tratamiento con dosis altas de icosapent etilo reduce las revascularizaciones coronarias en pacientes tratados con estatinas y niveles elevados de triglic\u00e9ridos (TG).<\/span><\/div>\n
Peterson BE, Bhatt DL, Steg Ph.G, et al. Reducci\u00f3n de la revascularizaci\u00f3n con icosapent et\u00edlico: conclusiones de REDUCE-IT REVASC. Circulation 2020; doi 10.1161\/CIRCULATIONAHA.120.050276. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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STRENGTH: un ensayo de resultados neutros para los \u00e1cidos grasos omega-3<\/span><\/h3>\n
4 de enero de 2021<\/span><\/h6>\n
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El tratamiento con dosis altas de \u00e1cidos grasos omega-3 (una formulaci\u00f3n carbox\u00edlica de \u00e1cido eicosapentaenoico [EPA] y \u00e1cido docosahexaenoico [DHA]) no redujo los principales acontecimientos cardiovasculares adversos (MACE) en pacientes tratados con estatinas, con dislipidemia aterog\u00e9nica y alto riesgo cardiovascular.<\/span><\/div>\n
Nicholls SJ, Lincoff AM, Garcia M, et al. Efecto de las altas dosis de \u00e1cidos grasos omega-3 frente al aceite de ma\u00edz sobre los principales acontecimientos cardiovasculares adversos en pacientes con alto riesgo cardiovascular: El ensayo cl\u00ednico aleatorizado STRENGTH. JAMA 2020; doi: 10.1001\/jama.2020.22258. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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

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EVAPORAR: El icosapent et\u00edlico 4 g\/d\u00eda frena la progresi\u00f3n de la aterosclerosis<\/span><\/h3>\n
5 de octubre de 2020<\/span><\/h6>\n
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Los resultados de EVAPORATE (Efecto de la vascepa en la mejora de la aterosclerosis coronaria en personas con triglic\u00e9ridos elevados que toman terapia con estatinas) aportan informaci\u00f3n sobre el mecanismo del beneficio de las dosis altas de icosapent etilo demostrado en el hist\u00f3rico estudio REDUCE-IT.<\/span><\/div>\n
Budoff MJ, Bhatt DL, Kinninger A et al. Efecto del icosapent etil en la progresi\u00f3n de la aterosclerosis coronaria en pacientes con triglic\u00e9ridos elevados en tratamiento con estatinas: resultados finales del ensayo EVAPORATE. Eur Heart J 2020; doi:10.1093\/eurheartj\/ehaa652 <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

[\/et_pb_text][et_pb_button button_url=\u00bb@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjI1MTg1NSIsImVuYWJsZV9odG1sIjoib2ZmIn19@\u00bb url_new_window=\u00bbon\u00bb button_text=\u00bbSigue leyendo\u00bb button_alignment=\u00bbright\u00bb _builder_version=\u00bb4.27.4″ _dynamic_attributes=\u00bbbutton_url\u00bb _module_preset=\u00bb9bc3f405-43a0-4056-a483-11952257355c\u00bb button_bg_color=\u00bbRGBA(255,255,255,0)\u00bb button_icon=\u00bb$||divi||400″ button_icon_color=\u00bbgcid-primary-color\u00bb button_on_hover=\u00bboff\u00bb custom_margin=\u00bb|44px|||false|false\u00bb global_colors_info=\u00bb{%22gcid-primary-color%22:%91%22button_text_color%22,%22button_icon_color%22%93}\u00bb][\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb4.27.4″ _module_preset=\u00bbdefault\u00bb background_color=\u00bbgcid-b673dc17-1b2a-464e-affa-1bf1ab41c0fd\u00bb custom_margin=\u00bb25px||||false|false\u00bb custom_padding=\u00bb||0px|||\u00bb border_radii=\u00bbon|20px|20px|20px|20px\u00bb global_colors_info=\u00bb{%22gcid-b673dc17-1b2a-464e-affa-1bf1ab41c0fd%22:%91%22background_color%22%93}\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_3_text_color=\u00bbgcid-4907c8d4-9eff-49de-91ce-43a2d3a729cf\u00bb header_6_text_color=\u00bbgcid-secondary-color\u00bb custom_margin=\u00bb||-12px|||\u00bb custom_padding=\u00bb|28px||28px|false|false\u00bb link_option_url_new_window=\u00bbon\u00bb global_colors_info=\u00bb{%22gcid-primary-color%22:%91%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22%93,%22gcid-4907c8d4-9eff-49de-91ce-43a2d3a729cf%22:%91%22header_3_text_color%22%93,%22gcid-secondary-color%22:%91%22header_6_text_color%22%93}\u00bb]<\/p>\n

Niveles elevados de colesterol remanente: una necesidad cl\u00ednica no cubierta en la prevenci\u00f3n secundaria<\/span><\/h3>\n
20 de julio de 2020<\/span><\/h6>\n
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Nuevos datos del Estudio de la Poblaci\u00f3n General de Copenhague ponen de relieve la importancia de abordar los niveles elevados de colesterol remanente no en ayunas en personas con enfermedad cardiovascular ateroscler\u00f3tica.<\/span><\/div>\n
Langsted A, Madsen CM, Nordestgaard BG. Contribuci\u00f3n del colesterol remanente al riesgo cardiovascular. J Intern Med 2020; doi: 10.1111\/joim.13059. En l\u00ednea antes de impresi\u00f3n. <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

[\/et_pb_text][et_pb_button button_url=\u00bb@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF9saW5rX3VybF9wYWdlIiwic2V0dGluZ3MiOnsicG9zdF9pZCI6IjI1MTg2NiIsImVuYWJsZV9odG1sIjoib2ZmIn19@\u00bb url_new_window=\u00bbon\u00bb button_text=\u00bbSigue leyendo\u00bb button_alignment=\u00bbright\u00bb _builder_version=\u00bb4.27.4″ _dynamic_attributes=\u00bbbutton_url\u00bb _module_preset=\u00bb9bc3f405-43a0-4056-a483-11952257355c\u00bb button_bg_color=\u00bbRGBA(255,255,255,0)\u00bb button_icon=\u00bb$||divi||400″ button_icon_color=\u00bbgcid-primary-color\u00bb button_on_hover=\u00bboff\u00bb custom_margin=\u00bb|44px|||false|false\u00bb global_colors_info=\u00bb{%22gcid-primary-color%22:%91%22button_text_color%22,%22button_icon_color%22%93}\u00bb][\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=\u00bb4.27.4″ _module_preset=\u00bbdefault\u00bb background_color=\u00bbgcid-b673dc17-1b2a-464e-affa-1bf1ab41c0fd\u00bb custom_margin=\u00bb25px||||false|false\u00bb custom_padding=\u00bb||0px|||\u00bb border_radii=\u00bbon|20px|20px|20px|20px\u00bb global_colors_info=\u00bb{%22gcid-b673dc17-1b2a-464e-affa-1bf1ab41c0fd%22:%91%22background_color%22%93}\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_3_text_color=\u00bbgcid-4907c8d4-9eff-49de-91ce-43a2d3a729cf\u00bb header_6_text_color=\u00bbgcid-secondary-color\u00bb custom_margin=\u00bb||-12px|||\u00bb custom_padding=\u00bb|28px||28px|false|false\u00bb link_option_url_new_window=\u00bbon\u00bb global_colors_info=\u00bb{%22gcid-primary-color%22:%91%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22,%22quote_text_color%22%93,%22gcid-4907c8d4-9eff-49de-91ce-43a2d3a729cf%22:%91%22header_3_text_color%22%93,%22gcid-secondary-color%22:%91%22header_6_text_color%22%93}\u00bb]<\/p>\n

Las lipoprote\u00ednas remanentes se asocian al riesgo de estenosis a\u00f3rtica<\/span><\/h3>\n
2 de junio de 2020<\/span><\/h6>\n
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Los datos del Estudio de la Poblaci\u00f3n General de Copenhague muestran que el aumento de los niveles de triglic\u00e9ridos (TG) y colesterol remanente incrementa el riesgo de estenosis a\u00f3rtica.<\/span><\/div>\n
Kaltoft M, Langsted A, Nordestgaard BG. Triglic\u00e9ridos y colesterol remanente asociados al riesgo de estenosis de la v\u00e1lvula a\u00f3rtica: Aleatorizaci\u00f3n mendeliana en el Estudio de la Poblaci\u00f3n General de Copenhague. Eur Heart J 2020. doi: 10.1093\/eurheartj\/ehaa172 <\/em><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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M\u00e1s datos de REDUCE-IT: Impacto en el total de eventos cardiovasculares<\/span><\/h3>\n
19 de marzo de 2020<\/span><\/h6>\n
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El icosapent et\u00edlico reduce la carga de acontecimientos primarios de primera vez y totales en pacientes con diabetes mellitus tipo 2 y triglic\u00e9ridos elevados que reciben tratamiento de base con estatinas.<\/span><\/div>\n
Bhatt DL, Steg PG, Miller M et al. Efectos del icosapent etil en los eventos isqu\u00e9micos totales. De REDUCE-IT. J Am Coll Cardiol 2019;73:2791’\u00c4\u00ec802. <\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Una nueva terapia antisentido dirigida a la APOC3 hep\u00e1tica mejora el perfil aterog\u00e9nico en pacientes hipertriglicerid\u00e9micos<\/span><\/h3>\n
17 de febrero de 2020<\/span><\/h6>\n
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La dosificaci\u00f3n m\u00faltiple con este oligonucle\u00f3tido en antisentido del ARNm APOC3 conjugado con N-acetilgalactosamina (GalNAc3) redujo los niveles de triglic\u00e9ridos en un 70% aproximadamente en sujetos con hipertrigliceridemia.<\/span><\/div>\n
Alexander VJ, Xia S, Hurh E et al. F\u00e1rmaco antisentido conjugado con N-acetilgalactosamina para los niveles de ARNm APOC3, triglic\u00e9ridos y lipoprote\u00ednas aterog\u00e9nicas. Eur Heart Journal 2019;40, 2785’\u00c4\u00ec96. <\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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

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Estudio Treat Stroke to Target: Un objetivo m\u00e1s bajo de colesterol de lipoprote\u00ednas de baja densidad tras un ictus reduce los acontecimientos cardiovasculares<\/span><\/h3>\n
19 de diciembre de 2019<\/span><\/h6>\n
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En pacientes con un ictus isqu\u00e9mico o un accidente isqu\u00e9mico transitorio (AIT) y evidencia de enfermedad ateroscler\u00f3tica, reducir los niveles de colesterol de lipoprote\u00ednas de baja densidad (LDL-C) a < 70 mg\/dL (<1,8 mmol\/L) reduce el riesgo de posteriores acontecimientos cardiovasculares (CV) en comparaci\u00f3n con un objetivo m\u00e1s elevado (90 a 110 mg\/dL [2,3 a 2,8 mmol\/L]).<\/span><\/div>\n
Amarenco P, Kim JS, Labreuche J et al. Comparaci\u00f3n de dos objetivos de colesterol LDL tras un ictus isqu\u00e9mico. N Engl J Med 2019; DOI: 10.1056\/NEJMoa1910355 <\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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REDUCE-LO: Centrarse en los triglic\u00e9ridos elevados reduce el riesgo cardiovascular residual<\/span><\/h3>\n
19 de julio de 2019<\/span><\/h6>\n
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El ensayo REDUCE-IT (Reduction of Cardiovascular Events with EPA-Intervention Trial) demostr\u00f3 que, en pacientes de alto riesgo tratados con estatinas y con hipertrigliceridemia residual, el tratamiento con icosapent etilo, un \u00e9ster et\u00edlico purificado del \u00e1cido eicosapentaenoico (EPA), redujo los principales acontecimientos cardiovasculares en un 25%. El tratamiento con icosapent etil tambi\u00e9n redujo sustancialmente la carga de acontecimientos isqu\u00e9micos totales. <\/span><\/div>\n
Bhatt DL, Steg PG, Miller M et al. Reducci\u00f3n del riesgo cardiovascular con icosapent et\u00edlico para la hipertrigliceridemia. N Engl J Med 2019;380:11-22. Bhatt DL, Steg PG, Miller M et al. Efectos del icosapent etilo en los eventos isqu\u00e9micos totales: De REDUCE-IT. J Am Coll Cardiol 2019;73:2791-802. <\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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

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Noticias de CANTOS: La modulaci\u00f3n de la v\u00eda de se\u00f1alizaci\u00f3n de la interleucina-6 reduce los acontecimientos cardiovasculares<\/span><\/h3>\n
6 de noviembre de 2018<\/span><\/h6>\n
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Nuevos datos del Estudio de Resultados de la Trombosis Antiinflamatoria con Canakinumab (CANTOS) aportan pruebas de concepto de que actuar sobre la v\u00eda de la interleucina-6 (IL-6) con canakinumab reduce los episodios cardiovasculares independientemente de la reducci\u00f3n de l\u00edpidos.<\/span><\/div>\n
Ridker PM, Libby P, MacFadyen JG et al. Modulaci\u00f3n de la v\u00eda de se\u00f1alizaci\u00f3n de la interleucina 6 y tasas de incidencia de acontecimientos ateroscler\u00f3ticos y mortalidad por cualquier causa: an\u00e1lisis del Estudio de Resultados de la Trombosis Antiinflamatoria con Canakinumab (CANTOS). Eur Heart J 2018; doi:10.1093\/eurheartj\/ehy310 <\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Hitos de R3iEn los \u00faltimos 15 a\u00f1os, grandes ensayos cl\u00ednicos han demostrado que, aunque el tratamiento con estatinas reduce los principales acontecimientos cardiovasculares en un 25-35%, sigue existiendo un riesgo cardiovascular residual considerable. Adem\u00e1s, las terapias multifactoriales agresivas en la diabetes tipo 2 no consiguen prevenir totalmente las complicaciones microvasculares. Esta secci\u00f3n examina estos hallazgos, […]<\/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-252998","page","type-page","status-publish","hentry"],"yoast_head":"\nHitos R3i: Definici\u00f3n de los Ensayos en Riesgo Residual<\/title>\n<meta name=\"description\" content=\"Explora los Hitos R3i, que presentan ensayos cl\u00ednicos definitorios que dieron forma a la comprensi\u00f3n del riesgo cardiovascular residual.\" \/>\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\/hitos-de-r3i\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hitos R3i: 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