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Efecto de la terapia con estatinas en los resultados clínicos en pacientes con riesgos cardiovasculares: una revisión
Kiyan Ghani Khan1, Priyadeep Kaur2, Mehak Bhagat3
1Internal Medicine, Baqai Medical University, Karachi, PAK.
Cureus
|August 20, 2025
Resumen
El tratamiento con estatinas reduce significativamente la mortalidad por cualquier causa y los eventos cardiovasculares adversos mayores (MACE). Sin embargo, su impacto en la mortalidad y las hospitalizaciones cardiovasculares requiere un estudio más profundo, lo que pone de relieve la necesidad de estrategias complementarias de gestión del riesgo.
Área de la Ciencia:
- Cardiología
- Farmacología
- Salud pública
Sus antecedentes:
- Las estatinas son los principales agentes para reducir el colesterol de lipoproteína de baja densidad (LDL).
- La reducción efectiva de LDL reduce el riesgo de aterosclerosis y de eventos cardiovasculares.
- Los adultos con factores de riesgo cardiovascular o enfermedad cardiovascular establecida (ECV) son poblaciones clave.
Objetivo del estudio:
- Revisar sistemáticamente y meta- analizar el impacto de la terapia con estatinas en la mortalidad y los eventos cardiovasculares adversos mayores (MACE).
- Evaluar los efectos de las estatinas en la mortalidad por cualquier causa, la mortalidad cardiovascular, el MACE (ataque cardíaco, accidente cerebrovascular, revascularización) y la hospitalización cardiovascular.
- Evaluar la eficacia de las estatinas en adultos con o con riesgo de enfermedad cardiovascular.
Principales métodos:
- Búsqueda sistemática de la literatura de PubMed, Google Scholar y Cochrane Central (2013-2024).
- La inclusión de ensayos controlados aleatorios, cohortes prospectivas y estudios retrospectivos.
- Metanálisis del modelo de efectos aleatorios con evaluación de la heterogeneidad (estadística I2).
Principales resultados:
- Siete estudios (506.813 pacientes) mostraron que las estatinas redujeron significativamente la mortalidad por cualquier causa (RR 0,60) y la MACE (RR 0,75).
- Se observó una alta heterogeneidad en los resultados de mortalidad, lo que sugiere variaciones en las poblaciones de estudio y los tipos de estatinas.
- No se observaron tendencias significativas en la mortalidad cardiovascular (RR 0, 74) y no se observó una reducción significativa en las hospitalizaciones cardiovasculares (RR 0, 97).
Conclusiones:
- Se ha confirmado que la terapia con estatinas reduce significativamente la mortalidad por cualquier causa y la EMAC, lo que respalda su papel en la reducción del riesgo cardiovascular.
- El efecto de las estatinas sobre la mortalidad cardiovascular y la hospitalización cardiovascular requiere más investigación.
- Pueden ser necesarias estrategias complementarias para reducir aún más los ingresos hospitalarios en pacientes tratados con estatinas.
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