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Tratamiento con estatinas en niños con hipercolesterolemia familiar: cuanto más jóvenes, mejor
Jessica Rodenburg1, Maud N Vissers, Albert Wiegman
1Academic Medical Centre, Department of Vascular Medicine, University of Amsterdam, The Netherlands.
Circulation
|August 1, 2007
Resumen
El tratamiento temprano con estatinas en niños con hipercolesterolemia familiar reduce significativamente la progresión del espesor carotídeo íntima-medio (IMT). Este estudio a largo plazo confirma que el inicio temprano de la estatina es beneficioso para prevenir la aterosclerosis en adolescentes.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Endocrinología Pediátrica Endocrinología pediátrica.
- Farmacología Farmacología.
Sus antecedentes:
- Un ensayo aleatorizado previo mostró que la pravastatina regresionaba el espesor íntima-media de la carótida (IMT) en niños con hipercolesterolemia familiar.
- Se inició un estudio de seguimiento a largo plazo para evaluar el impacto de la edad de inicio de las estatinas en la TMI carotídea.
- También se evaluó la seguridad de la terapia a largo plazo con estatinas en pacientes pediátricos.
Objetivo del estudio:
- Explorar la relación entre la edad de inicio de las estatinas y la IMT carotídea.
- Evaluar la seguridad y eficacia a largo plazo del tratamiento con pravastatina en niños con hipercolesterolemia familiar.
Principales métodos:
- Seguimiento de 214 niños de un ensayo previo controlado con placebo, con 186 proporcionando datos para el análisis.
- Los niños continuaron el tratamiento con pravastatina (20 o 40 mg) después del estudio inicial.
- Las mediciones del IMT carotídeo y los parámetros de seguridad (lípidos, pruebas de laboratorio) fueron monitoreados durante un promedio de 4,5 años.
Principales resultados:
- La edad al inicio de la estatina fue un predictor independiente de la IMT carotídea después del seguimiento.
- El inicio más temprano del tratamiento con estatinas se asoció con un IMT carotídeo más pequeño.
- No se reportaron eventos adversos de laboratorio graves; el tratamiento con estatinas no afectó la maduración sexual.
Conclusiones:
- El inicio temprano del tratamiento con estatinas retrasa la progresión de la IMT carotídea en adolescentes y adultos jóvenes.
- Este estudio proporciona evidencia de que la terapia temprana con estatinas en niños con hipercolesterolemia familiar puede prevenir la aterosclerosis durante la adolescencia.
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