Terapia de alta intensidad con Atorvastatina de 40 miligramos para prevención secundaria en pacientes diagnosticados con ACV isquémico en la Clínica Misericordia Internacional de Barranquilla, enero – agosto 2021

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dc.contributor.advisorVargas Manotas, José Enrique
dc.contributor.advisorNavarro Baene, Gina
dc.contributor.authorCrespo Vizcaíno, Estiven de Jesús
dc.contributor.authorCarlos José, Brito Jácome
dc.coverage.spatialBarranquillaspa
dc.creator.emailestiven95@outlook.comspa
dc.creator.emailcarlosbritto9@gmail.comspa
dc.date.accessioned2022-12-05T20:45:30Z
dc.date.available2022-12-05T20:45:30Z
dc.date.created2022-06
dc.description.abstractINTRODUCCIÓN: El accidente cerebrovascular (ACV) se define como un déficit neurológico atribuido a una lesión focal aguda del sistema nervioso central por una causa vascular. Se estima que hay 9,6 millones de ACV isquémicos a nivel mundial cada a–o, con una incidencia creciente en países de bajos y medianos ingresos. La terapia de alta intensidad con estatinas ha probado beneficio en prevención—n secundaria usando dosis de 80 mg de atorvastatina. OBJETIVO: Se pretende determinar el probable beneficio de dosis de 40 mg de atorvastatina manteniendo los beneficios cardiovasculares. METODOLOGÍA: Este es un estudio descriptivo, longitudinal y retrospectivo, se evaluaron 48 pacientes mayores de 18 a–os diagnosticados con ACV quienes recib’an atorvastatina en dosis de 40 mg diarios como prevención secundaria. Se caracterizaron sociodemográfica y clínicamente y se evalúa tasa de recurrencia en un periodo menor y mayor de 180 días. RESULTADOS: Tras la ingesta de atorvastatina de 40 mg, la muestra estudiada presenta una tasa de recurrencia de ACV de s—lo 12,5%, la mayoría presenta recurrencia luego de 180 días de seguimiento (50%), principalmente en pacientes con hipertensión arterial (88,3%), tabaquismo (77,1%) y sedentarismo (47,9%). CONCLUSIONES: Se determina el probable beneficio de atorvastatina de 40 mg en prevención secundaria de pacientes diagnosticados con ACV isquémico, a pesar de las limitaciones presentadas se observa una tendencia de baja recurrencia de ACV. Los resultados obtenidos dan pie al desarrollo de producción investigativa para comprobar la efectividad de la dosis de 40 mg de atorvastatina y demás consideraciones.spa
dc.description.abstractenglishBACKGROUND: Stroke is defined as a neurological deficit attributed to an acute focal lesion of central nervous system due to a vascular cause. There are an estimated 9.6 million ischemic strokes worldwide each year, with an increasing incidence in low and middle-income countries. High-intensity statin therapy has proven beneficial in secondary prevention using 80 mg doses of atorvastatin. OBJECTIVE: It is intended to determine probable benefit of 40 mg dose of atorvastatin; maintaining cardiovascular benefits. MATERIALS AND METHODS: This is a descriptive, longitudinal and retrospective study. 48 patients older than 18 years diagnosed with isquemic stroke who received atorvastatin in doses of 40 mg daily as secondary prevention were evaluated. They were characterized in terms of sociodemographic and clinical features and recurrence rate was evaluated in a period of less than and greater than 180 days. RESULTS: After the intake of atorvastatin 40 mg, studied sample presented a recurrence rate of stroke of only 12.5%, majority presented recurrence after 180 days of follow-up (50%), mainly in patients with arterial hypertension (88.3%), smoking (77.1%) and sedentary lifestyle (47.9%). CONCLUSIONS: The probable benefit of atorvastatin 40 mg in secondary prevention of patients diagnosed with ischemic stroke was determined, despite the limitations presented, a trend of low stroke recurrence was observed. The results obtained give rise to the development of investigation to prove the effectiveness of 40 mg dose of atorvastatin and other considerations.spa
dc.description.sponsorshipUniversidad Libre Seccional Barranquilla -- Facultad de Ciencias de la Salud -- Especialización en Medicina Internaspa
dc.formatPDFspa
dc.identifier.urihttps://hdl.handle.net/10901/23841
dc.relation.referencesCampbell B, Khatri P. Stroke. Lancet. 2020; 396: 129–42spa
dc.relation.referencesAmruta N, Rahman A, Pinteaux E, Bix G. Neuroinflammation and fibrosis in stroke: The good, the bad and the ugly. Journal of Neuroimmunology. 2020; 346:577318spa
dc.relation.referencesPandian JD, Gall SL, Kate MP, et al. Prevention of stroke: a global perspective. Lancet. 2018; 392: 1269–78spa
dc.relation.referencesGBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019; 18: 439-58spa
dc.relation.referencesAmarenco P, Bogousslavsky J, Callahan A 3rd, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006; 355: 549–59spa
dc.relation.referencesKazi D, Penko J, Bibbins-Domingo K. Statins for Primary Prevention of Cardiovascular Disease Review of Evidence and Recommendations for Clinical Practice. Med Clin N Am. 2017; 101:689–699spa
dc.relation.referencesThompson P, Panza G, Zaleski A, Taylor B. Statin-Associated Side Effects. J Am Coll Cardiol. 2016;67(20):2395-2410spa
dc.relation.referencesRojas-Fernandez C, Hudani Z, Bittner V. Statins and Cognitive Side Effects What Cardiologists Need to Know. Cardiol Clin. 2015;33: 245–256spa
dc.relation.referencesChowdhury R, Khan H, Heydon E, et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J 2013; 34:2940–8spa
dc.relation.referencesMurphy S, Werring D. Stroke: causes and clinical features. Medicine. 2020;48(9): 561-566spa
dc.relation.referencesYanez N, Useche J, Bayona H, Porras A, Carrasquilla G. Analyses of Mortality and Prevalence of Cerebrovascular Disease in Colombia, South America (2014-2016): A Cross-Sectional and Ecological Study. J Stroke Cerebrovasc Dis. 2020;29(5):104699spa
dc.relation.referencesCaprio F, Sorond F. Cerebrovascular Disease Primary and Secondary Stroke Prevention. Med Clin N Am. 2019;103: 295–308spa
dc.relation.referencesStone N, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol. 2014; 63: 2889–2934spa
dc.relation.referencesCui C, Dong S, Chen N, Bao J, He L. Low-dose statin pretreatment improves function and prognosis of recurrent ischemic stroke patients. Ther Adv Neurol Disord. 2020; 13:1-11spa
dc.relation.referencesO'Brien EC, Greiner MA, Xian Y, Fonarow GC, Olson DM, Schwamm LH, et al. Clinical Effectiveness of Statin Therapy After Ischemic Stroke: Primary Results From the Statin Therapeutic Area of the Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research (PROSPER) Study. Circulation. 2015;132(15):1404-13spa
dc.relation.referencesAmarenco P, Kim JS, Labreuche J, Charles H, Giroud M, Lee BC, et al. Treat Stroke to Target Investigators. Benefit of Targeting an LDL (Low-Density Lipoprotein) Cholesterol <70 mg/dL During 5 Years After Ischemic Stroke. Stroke. 2020;51(4):1231-1239spa
dc.relation.referencesYoshimura S, Uchida K, Daimon T, Takashima R, Kimura K, Morimoto T. Randomized Controlled Trial of Early Versus Delayed Statin Therapy in Patients with Acute Ischemic Stroke: ASSORT Trial (Administration of Statin on Acute Ischemic Stroke Patient). Stroke. 2017;48(11):3057-3063spa
dc.relation.referencesAmarenco P, Bogousslavsky J, Callahan A, Goldstein L, Hennerici H, Rudolph A, et al. High-dose atorvastatin after stroke or transient ischemic attack. N Engl J Med. 2006; 355:549-59spa
dc.relation.referencesChoi KH, Seo WK, Park MS, Kim JT, Chung JW, Bang OY, et al. Effect of Statin Therapy on Outcomes of Patients with Acute Ischemic Stroke and Atrial Fibrillation. J Am Heart Assoc. 2019;8(24): e013941spa
dc.relation.referencesAmarenco P, Kim JS, Labreuche J, Charles H, Abtan J, Béjot Y, et al. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. N Engl J Med. 2020;382(1):9-19spa
dc.relation.referencesParker BA, Capizzi JA, Grimaldi AS, Clarkson PM, Cole SM, Keadle J, et al. Effect of statins on skeletal muscle function. Circulation. 2013; 127(1):96– 103spa
dc.relation.referencesSacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44(7): 2064– 89spa
dc.relation.referencesAdams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke. 1993; 24(1): 35-41spa
dc.relation.referencesChugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin E, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014; 129(8): 837–47spa
dc.relation.referencesO’Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet. 2016; 388(10046): 761-775spa
dc.relation.referencesArch AE, Weisman DC, Coca S, Nystrom KV, Wira CR, Schindler JL. Missed ischemic stroke diagnosis in the emergency department by emergency medicine and neurology services. Stroke. 2016; 47: 668–73spa
dc.relation.referencesHand PJ, Kwan J, Lindley RI, Dennis MS, Wardlaw JM. Distinguishing between stroke and mimic at the bedside: the Brain Attack Study. Stroke. 2006; 37: 769–75spa
dc.relation.referencesCampbell B, Christensen S, Levi C, Desmond P, Donnan G, Davis S, et al. Comparison of computed tomography perfusion and magnetic resonance 65 imaging perfusion-diffusion mismatch in ischemic stroke. Stroke. 2012;43: 2648–53spa
dc.relation.referencesLanghorne P, Kamachandra S. Organised inpatient (stroke unit) care for stroke: network meta-analysis. Cochrane Database Syst Rev. 2020; 4:1-116spa
dc.relation.referencesThe National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995; 333: 1581–87spa
dc.relation.referencesEmberson J, Lees KR, Lyden P, Blackwell L, Albers G, Bluhmki E, et al. Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet. 2014; 384(9958): 1929–35spa
dc.relation.referencesNoncommunicable Diseases Progress Monitor, 2017. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGOspa
dc.relation.referencesDiener HC, Hankey GJ. Primary and Secondary Prevention of Ischemic Stroke and Cerebral Hemorrhage: JACC Focus Seminar. J Am Coll Cardiol. 2020;75(15):1804-1818spa
dc.relation.referencesCollins R, Reith C, Emberson J, Armitage J, Baigent C, Blackwell L, et al. Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet. 2016; 388(10059):2532–61spa
dc.relation.referencesStone N, Robinson J, Lichtenstein A, Merz C, Blum C, Eckel R, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol.2014; 63:2889–2934spa
dc.relation.referencesThompson P, Panza G, Zaleski A, Taylor B. Statin-Associated Side Effects. J Am Coll Cardiol. 2016;67(20):2395-2410spa
dc.relation.referencesAdhyaru BB, Jacobson TA. Safety and efficacy of statin therapy. Nat Rev Cardiol. 2018;15(12):757-769spa
dc.relation.referencesRosenson R, Miller K, Bayliss M, Sanchez R, Baccara-Dinet M, Chibedi-DeRoche D, et al. The statin-associated muscle symptom clinical index (SAMSCI): revision for clinical use, content validation, and inter-rater reliability. Cardiovasc Drugs Ther. 2017;31(2): 179–186spa
dc.relation.referencesStroes E, Thompson P, Corsini A, Vladutiu G, Raal F, Ray K, et al. Statinassociated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur Heart J. 2015;36(17):1012–1022spa
dc.relation.referencesPreiss D, Welsh P, Murphy S, Ho J, Waters D, DeMicco D, et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA. 2011;305(24): 2556–2564spa
dc.relation.referencesBays H, Cohen D, Chalasani N, Harrison S. The National Lipid Association’s Statin Safety Task Force. An assessment by the Statin Liver Safety Task Force: 2014 update. J Clin Lipidol. 2014; 8:47–57spa
dc.relation.referencesOtt B, Daiello L, Dahabreh I, Springate B, Bixy K, Murali M, et al. Do statins impair cognition? A systematic review and meta-analysis of randomized controlled trials. J Gen Intern Med. 2015;30(3): 348–358spa
dc.relation.referencesEaston JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009;40:2276- 2293spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.licenseAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subjectAccidente cerebrovascularspa
dc.subjectPrevención secundariaspa
dc.subjectFactores de riesgospa
dc.subjectEfectividadspa
dc.subjectAtorvastatinaspa
dc.subjectRecurrenciaspa
dc.subject.lembAccidente cerebrovascularspa
dc.subject.lembAtorvastatinaspa
dc.subject.lembPrevención secundariaspa
dc.subject.subjectenglishStrokespa
dc.subject.subjectenglishSecondary preventionspa
dc.subject.subjectenglishRisk factorsspa
dc.subject.subjectenglishRecurrencespa
dc.subject.subjectenglishEffectivenessspa
dc.subject.subjectenglishAtorvastatinspa
dc.titleTerapia de alta intensidad con Atorvastatina de 40 miligramos para prevención secundaria en pacientes diagnosticados con ACV isquémico en la Clínica Misericordia Internacional de Barranquilla, enero – agosto 2021spa
dc.type.driverinfo:eu-repo/semantics/bachelorThesisspa
dc.type.localTesis de Especializaciónspa

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