Atorvastatin Effect on Aortic Dilatation and Valvular Calcification Progression in Bicuspid Aortic Valve (BICATOR): A Randomized Clinical Trial.

BACKGROUND: Ascending aorta dilation and aortic valve degeneration are common complications in patients with bicuspid aortic valve. Several retrospective studies have suggested the benefit of statins in reducing these complications. This study aimed to determine whether atorvastatin treatment is effective in reducing the growth of aortic diameters in bicuspid aortic valve and if it slows the progression of valve calcification. METHODS: In a randomized clinical trial, 220 patients with bicuspid aortic valve (43 women; 46±13 years of age) were included and treated with either 20 mg of atorvastatin per day or placebo for 3 years. Inclusion criteria were ≥18 years of age, nonsevere valvular dysfunction, nonsevere valve calcification, and ascending aorta diameter ≤50 mm. Computed tomography and echocardiography studies were performed at baseline and after 3 years of treatment. RESULTS: During follow-up, 28 patients (12.7%) discontinued medical treatment (15 on atorvastatin and 13 taking placebo). Thus, 192 patients completed the 36 months of treatment. Low-density lipoprotein cholesterol levels decreased significantly in the atorvastatin group (median [interquartile range], -30 mg/dL [-51.65 to -1.75 mg/dL] versus 6 mg/dL [-4, 22.5 mg/dL]; P<0.001). The maximum ascending aorta diameter increased with no differences between groups: 0.65 mm (95% CI, 0.45-0.85) in the atorvastatin group and 0.74 mm (95% CI, 0.45-1.04) in the placebo group (P=0.613). Similarly, no significant differences were found for the progression of the aortic valve calcium score (P=0.167) or valvular dysfunction. CONCLUSIONS: Among patients with bicuspid aortic valve without severe valvular dysfunction, atorvastatin treatment was not effective in reducing the progression of ascending aorta dilation and aortic valve calcification during 3 years of treatment despite a significant reduction in low-density lipoprotein cholesterol levels. REGISTRATION: URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2015-001808-57. URL: https://www.clinicaltrials.gov; Unique identifier: NCT02679261.

Caracterización de la tipología circadiana en estudiantes universitarios en relación con el tipo de carrera / Characterization of the circadian typology in university students in relation to the type of career

RESUMEN Fundamento: El cronotipo es un atributo de los seres humanos, que refleja su fase circadiana individual, y repercute en las funciones biológicas y psicológicas, tanto en la salud como en la enfermedad. Su estudio es particularmente valioso en escenarios educacionales. Objetivo: caracterizar el cronotipo de estudiantes universitarios en relación con el tipo de carrera que estudian. Métodos: e realizó un estudio analítico trasversal, en una serie de 273 estudiantes universitarios, seleccionados por muestreo aleatorio simple, estructurados en tres grupos bajo criterio de procedencia: 88 de Ciencias Técnicas, 88 de Ciencias Sociales y Humanísticas y 97 de Ciencias Médicas. Se exploró el cronotipo de cada sujeto por medio del Cuestionario de Matutinidad- Vespertinidad. Para cada grupo fueron calculadas las puntuaciones medias resultantes del cuestionario y las proporciones de individuos matutinos, intermedios y vespertinos. Resultados: las puntuaciones medias de los tres grupos estuvieron enmarcadas en el rango de cronotipo intermedio, y no se constaron diferencias estadísticamente significativas. El 67 % de los sujetos fueron clasificados como intermedios, el 23,8 % como matutinos y el 9,2 % como vespertinos; las proporciones de los cronotipos por grupos tampoco mostraron diferencias significativas. Conclusión: existió un claro predominio del cronotipo intermedio, seguido en frecuencia por el matutino y el vespertino. No se demostró que el tipo de carrera influyera en las puntuaciones, ni en las proporciones de las tipologías circadianas por grupos.

ABSTRACT Foundation: Chronotype is an attribute of human beings, which reflects its individual circadian phase, and affects biological and psychological functions, both in health and disease. Its study is particularly valuable in educational settings. Objective: to characterize the chronotype of university students in relation to the type of career they study. Methods: a cross-sectional analytical study was conducted in a series of 273 university students, selected by simple random sampling, structured in three groups based on provenance criteria: 88 from Technical Sciences, 88 from Social and Humanistic Sciences and 97 from Medical Sciences. The chronotype of each subject was explored through the Morningness and Eveningness Questionnaire. For each group the mean scores of the questionnaire and the proportions of morning, intermediate and evening individuals were calculated. Results: the mean scores of the three groups were framed in the intermediate chronotype range, and there were no statistically significant differences. Subjects were classified as 67% of as intermediate, 23.8% as morning and 9.2 % as evening; chronotype proportions by groups also showed no significant differences. Conclusion: there was a clear predominance of intermediate chronotype, followed in frequency by morning and evening. It was not demonstrated that the type of career influenced scores, nor in proportions of the circadian typologies by groups.