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Colesterol de lipoproteínas de baja densidad y resultados clínicos en pacientes con cirrosis hepática: un estudio de

Byung Sik Kim1, Jiyeong Kim2,3, Nayeon Choi2

  • 1Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Republic of Korea.

Annals of medicine
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Resumen

El aumento del colesterol de lipoproteínas de baja densidad (LDL-C) aumenta el riesgo de eventos cardiovasculares en pacientes con cirrosis hepática (CHE). Tanto los niveles bajos como los altos de LDL-C están relacionados con un mayor riesgo de muerte por todas las causas en esta población.

Palabras clave:
Enfermedades cardiovascularescirrosis hepáticacolesterol de lipoproteínas de baja densidadResultadoLas estatinas

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Área de la Ciencia:

  • Cardiología
  • Hepatología
  • Salud pública

Sus antecedentes:

  • La relación entre el colesterol de lipoproteínas de baja densidad (LDL-C) y los resultados clínicos en pacientes con cirrosis hepática no está bien establecida.
  • Comprender esta asociación es crucial para manejar el riesgo cardiovascular en personas con LC.

Objetivo del estudio:

  • Investigar la asociación entre los niveles de LDL-C y los eventos cardiovasculares.
  • Examinar la relación entre los niveles de LDL-C y la muerte por cualquier causa en pacientes con LC.

Principales métodos:

  • Un estudio de cohorte retrospectivo que utiliza una base de datos nacional de 303,988 pacientes con cáncer de páncreas.
  • Los pacientes se clasificaron en seis grupos de colesterol LDL (mg/ dl): < 70, 70-99, 100-129, 130-159, 160-189 y ≥190.
  • Los resultados primarios incluyeron un compuesto de infarto de miocardio e ictus isquémico y muerte por todas las causas.

Principales resultados:

  • Los niveles más altos de LDL-C mostraron un aumento dependiente de la dosis en el riesgo de eventos cardiovasculares.
  • Los pacientes con LDL-C ≥190 mg/ dl tenían un riesgo 1,77 veces mayor de eventos cardiovasculares compuestos y un riesgo 2,96 veces mayor de infarto de miocardio en comparación con el grupo de < 70 mg/ dl.
  • Se observó una relación en forma de U para la muerte por cualquier causa, con el riesgo más bajo en el grupo de LDL-C de 130 a 159 mg/dl.

Conclusiones:

  • Los niveles elevados de LDL-C se asocian significativamente con un mayor riesgo de eventos cardiovasculares en pacientes con LC.
  • Tanto los niveles bajos como los altos de LDL-C se correlacionan con un mayor riesgo de mortalidad por cualquier causa en esta población.
  • Se recomiendan estrategias de manejo de lípidos individualizadas para pacientes con cirrosis hepática.