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Terapia con estatinas, eventos cardiovasculares y mortalidad total en el estudio del corazón y el estudio de
David M Herrington1, Eric Vittinghoff, Feng Lin
1Department of Internal Medicine/Cardiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. dherring@wfubmc.edu
Circulation
|June 26, 2002
Resumen
El uso de estatinas en mujeres posmenopáusicas con enfermedad cardíaca redujo significativamente los eventos cardiovasculares, los eventos tromboembólicos venosos y la mortalidad total. Estos hallazgos apoyan la terapia con estatinas para mujeres elegibles con enfermedad coronaria.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Farmacología Farmacología.
- Salud de la Mujer Salud de la Mujer.
Sus antecedentes:
- Los resultados cardiovasculares de las estatinas se establecen en los hombres, pero menos en las mujeres.
- Los efectos combinados de las estatinas y la terapia de reemplazo hormonal (TRH) en los resultados cardiovasculares siguen siendo inciertos.
Objetivo del estudio:
- Examinar los efectos del uso de estatinas en los eventos cardiovasculares y la mortalidad en mujeres posmenopáusicas con enfermedad cardíaca.
- Investigar la interacción entre el uso de estatinas y la terapia de reemplazo hormonal (TRH) en los resultados cardiovasculares.
Principales métodos:
- Análisis de los datos del Estudio del Corazón y el Estudio de Reemplazo de Estrógeno / Progestina (HERS), un ensayo clínico aleatorizado.
- Comparación no aleatoria de usuarios y no usuarios de estatinas entre 2763 mujeres posmenopáusicas con enfermedad cardíaca.
Principales resultados:
- Los usuarios de estatinas tuvieron tasas más bajas del resultado primario (infarto de miocardio no fatal o muerte por enfermedad coronaria) (RH=0.79, P=0.04).
- El uso de estatinas se asoció con una mortalidad total significativamente menor (RH = 0,67, P = 0,003) y eventos tromboembólicos venosos (RH = 0,45, P = 0,02).
- La terapia de reemplazo hormonal (TRH) aumentó el riesgo temprano de eventos primarios en los no usuarios de estatinas, pero no en los usuarios de estatinas; el análisis ajustado no mostró efecto de la TRH en el resultado primario.
Conclusiones:
- El uso de estatinas en mujeres posmenopáusicas con enfermedad coronaria está relacionado con una reducción de eventos cardiovasculares, eventos tromboembólicos venosos y mortalidad general.
- Estos hallazgos apoyan firmemente el uso de estatinas en mujeres elegibles con enfermedad coronaria existente.
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