Revista Espanola de Cardiologia Suplementos最新文献_第8页

Introducción 导言

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30016-0

Juan M. Ruiz-Nodar

引用次数: 0

Una historia resumida. La inhibición de la PCSK9 y su desarrollo clínico 一个简短的故事。PCSK9的抑制及其临床发展

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30011-1

José López-Sendón, Almudena Castro, Regina Dalmau

{"title":"Una historia resumida. La inhibición de la PCSK9 y su desarrollo clínico","authors":"José López-Sendón, Almudena Castro, Regina Dalmau","doi":"10.1016/S1131-3587(19)30011-1","DOIUrl":"10.1016/S1131-3587(19)30011-1","url":null,"abstract":"<div><p>Hypercholesterolaemia is one of the major cardiovascular risk factors; however, conventional treatment with diet, exercise and cholesterol-lowering drugs are insufficient to control low-density lipoprotein (LDL) cholesterol in a significant number of patients. Inhibition of the PCSK9 protein by using specific monoclonal antibodies increases the number of LDL cholesterol receptors in the hepatocyte, contributing to LDL destruction. The use of these drugs, whether as monotherapy or in combination with statins and ezetimibe, significantly reduces LDL cholesterol, allowing LDL cholesterol levels in most patients to be maintained within limits recommended by clinical practice guidelines. To determine their clinical efficacy, 3 multicenter trials of morbidity and mortality have been conducted with alirocumab, evolocumab and bococizumab. The trial involving evolocumab, a fully human monoclonal antibody, demonstrated a significant reduction of the primary efficacy endpoint, including cardiovascular mortality, myocardial infarction, stroke, unstable angina or myocardial revascularisation. However, no clinical benefit was observed with bococizumab (a humanised but not fully human monoclonal antibody), probably due to a decrease in efficacy secondary to the formation of anti-drug antibodies. This new therapeutic option is already used in clinical practice and is considered a new advance in the prevention of cardiovascular disease.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56634291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Medicina traslacional, tratamiento de las dislipemias y prevención secundaria: conclusiones 转化医学、血脂异常的治疗和二级预防:结论

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30014-7

Manuel Anguita Sánch

引用次数: 0

Factores determinantes del riesgo isquémico del paciente tras un infarto agudo de miocardio 急性心肌梗死后缺血性风险的决定因素

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30018-4

Juan M. Ruiz-Nodar , Emad Abu-Assi

引用次数: 2

Importancia de la medicina traslacional: mecanismos del beneficio del tratamiento de las dislipemias y su implicación en la reducción de la placa 转化医学的重要性:血脂异常治疗的益处机制及其在减少斑块中的作用

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30012-3

Mónica Domenecha , Ramón Estruch , Raúl Moreno , Manuel Anguita Sánchez

{"title":"Importancia de la medicina traslacional: mecanismos del beneficio del tratamiento de las dislipemias y su implicación en la reducción de la placa","authors":"Mónica Domenecha , Ramón Estruch , Raúl Moreno , Manuel Anguita Sánchez","doi":"10.1016/S1131-3587(19)30012-3","DOIUrl":"10.1016/S1131-3587(19)30012-3","url":null,"abstract":"<div><p>Cardiovascular disease continues to be the most common cause of morbidity and mortality in western countries. Hyperlipidaemia, including hypercholesterolemia and atherogenic dyslipidaemia, is one the main risk factors for atherosclerotic heart disease. Routine therapies for hypercholesterolaemia include HMG-CoA reductase inhibitors (statins), NPC1L1 inhibitors (ezetimibe), phytosterols, menacholyne K, bile salt sequestrants and PCSK9 inhibitors. New drugs under development are CEPT inhibitors, antisense oligonucleotides and inhibitors of microsomal triglyceride transfer protein. The association between hyperlipidaemia and atherosclerosis is well documented. Arterial wall remodelling, described by Glagov more than 3 decades ago, is a key phenomenon in coronary artery atherosclerosis. When atherosclerotic plaque increases, artery diameter also increases to compensate lumen reduction. It is only in the final stage of the process, when the increase in diameter is unable to compensate for plaque growth, that clinical ischaemia develops. In this article, we review the mechanisms of action of drugs used for the treatment of dyslipidaemia, and the role of lipid level control in plaque reversal.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82667296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Avances en el control lipídico, de la teoría a la práctica. El reto de la medicina traslacional 脂质控制的进展，从理论到实践。转化医学的挑战

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30013-5

Juan Cosin Sales , Regina Dalmau , Manuel Anguita Sánchez

{"title":"Avances en el control lipídico, de la teoría a la práctica. El reto de la medicina traslacional","authors":"Juan Cosin Sales , Regina Dalmau , Manuel Anguita Sánchez","doi":"10.1016/S1131-3587(19)30013-5","DOIUrl":"10.1016/S1131-3587(19)30013-5","url":null,"abstract":"<div><p>Lipid control is one of the pillars of secondary prevention, but despite multiple evidence showing that the risk of new cardiovascular events decreases with lower low-density lipoprotein cholesterol (LDL-C) levels, this remains the most poorly controlled risk factor in our patients. The development of new drugs, such as PCSK9 inhibitors, will help us to improve this problem, but programmes that improve the continuity of care between cardiologists and primary care physicians are also very important. Although good drugs are available, lipid goals will not be achieved unless they are used in our patients. Despite the clinical development of lipid-lowering therapies in the last few years, there is currently an important gap between the evidence generated by many clinical trials, reflected in the clinical practice guidelines, and its clinical application in our patients, contributing to the fact that a significant number of patients with established cardiovascular disease do not achieve lipid control targets, and consequently continue to be at high risk or have recurrent events. To narrow this gap, it seems necessary to critically analyse the main barriers and to develop strategies to solve these problems. Basic and clinical investigators, cardiologists and primary care physicians, other health professionals, scientific societies and health authorities working together will contribute to close the gap and to improve cardiovascular health outcomes.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56634469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Novedades en la evaluación del riesgo hemorrágico del paciente con cardiopatía isquémica 缺血性心脏病患者出血风险评估的新进展

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30019-6

Sergio Raposeiras Roubín , Albert Ariza Solé

{"title":"Novedades en la evaluación del riesgo hemorrágico del paciente con cardiopatía isquémica","authors":"Sergio Raposeiras Roubín , Albert Ariza Solé","doi":"10.1016/S1131-3587(19)30019-6","DOIUrl":"10.1016/S1131-3587(19)30019-6","url":null,"abstract":"<div><p>The assessment of bleeding risk is the limiting factor in determining the balance between the risk of ischemia and hemorrhage, which must be determined before the type and duration of antithrombotic therapy can be selected. The best data for estimating bleeding risk are available during hospitalization and several suitable risk scores have been developed and have undergone extensive validation and comparison. The CRUSADE bleeding score appears to be the most useful. In addition, several risk scores for assessing bleeding risk over the medium to long term after hospital discharge or after coronary artery revascularization have recently appeared, such as the PRECISE-DAPT (PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy), the PARIS (Patterns of non-Adherence to Anti-Platelet Regimens in Stented Patients), the DAPT (Dual AntiPlatelet Therapy) and the TRILOGY-ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) risk scores. All have demonstrated reasonably good predictive power but they have some important limitations, which mean that they will have to undergo comparative validation studies before their usefulness can be extended to patients treated with new antiplatelet agents (e.g. ticagrelor and prasugrel) and oral anticoagulants, including both vitamin K antagonists and direct-acting oral anticoagulants.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56634746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Introducción 导言

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30008-1

José López-Sendón

引用次数: 0

Indicación del tratamiento con doble antiagregación más allá del año. A quién y por qué 一年以上双抗聚集治疗的适应症。给谁，为什么

Revista Espanola de Cardiologia Suplementos Pub Date : 2017-01-01 DOI: 10.1016/S1131-3587(19)30020-2

Juan Carlos Gómez-Polo , David Vivas , Inmaculada Roldán

引用次数: 3

Escalas de evaluación del riesgo tromboembólico y hemorrágico en la fibrilación auricular 评估房颤血栓栓塞和出血性风险的量表

Revista Espanola de Cardiologia Suplementos Pub Date : 2016-01-01 DOI: 10.1016/S1131-3587(16)30011-5

Javier Pérez-Copete , María Asunción Esteve-Pastor , Vanessa Roldán , Mariano Valdés , Francisco Marín

{"title":"Escalas de evaluación del riesgo tromboembólico y hemorrágico en la fibrilación auricular","authors":"Javier Pérez-Copete , María Asunción Esteve-Pastor , Vanessa Roldán , Mariano Valdés , Francisco Marín","doi":"10.1016/S1131-3587(16)30011-5","DOIUrl":"10.1016/S1131-3587(16)30011-5","url":null,"abstract":"<div><p>Atrial fibrillation is the most prevalent cardiac arrhythmia in the general population. Its presence increases the risk of thromboembolic events five-fold. Antithrombotic therapy reduces this risk, but increases the risk of bleeding, with intracranial bleeding being the most feared complication. However, the risk varies between patients and, as a result, various thromboembolic risk scores have been developed in recent years (e.g. the CHADS<sub>2</sub>, CHA<sub>2</sub>DS<sub>2</sub>-VASc and ATRIA scores). The CHA<sub>2</sub>DS<sub>2</sub>-VASc score is recommended by clinical practice guidelines to help optimize antithrombotic therapy in patients with atrial fibrillation. In addition, these guidelines also recommend that both thromboembolic risk and the risk of bleeding should be assessed. A number of risk models have been proposed for assessing the bleeding risk in these patients (e.g. the HEMORR<sub>2</sub>HAGES, HAS-BLED, ATRIA and ORBIT-AF scores), but currently the majority of guidelines recommend the HAS-BLED score. Above all, it is essential that the net clinical benefit of antithrombotic therapy is assessed: the expected benefit of anticoagulation therapy should outweigh the expected harm caused by possible bleeding. Nevertheless, the ability of both thromboembolic and bleeding risk scores to predict clinical events is only moderate. Consequently, alternative approaches, such as the use of biomarkers (e.g. D-dimer, von Willebrand factor and GDF-15), could help evaluate the thromboembolic risk in individual patients with atrial fibrillation.</p></div>","PeriodicalId":34926,"journal":{"name":"Revista Espanola de Cardiologia Suplementos","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1131-3587(16)30011-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56633720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6