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1.
Br J Nutr ; 121(12): 1365-1375, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30887937

RESUMO

Diabetes mellitus is a global epidemic, characterised as a heterogeneous group of metabolic disorders associated with high risk of CVD. Green banana biomass, which is composed of resistant starches (RS) and cannot be hydrolysed by amylases, delays gastric emptying and modulates insulin sensitivity, thus contributing to improve metabolic disorders. The aim of the present study was to investigate the effects of consumption of RS from green banana biomass on body composition, fasting plasma glucose, glycated Hb (HbA1c) and homeostasis model assessment of insulin resistance in subjects with pre-diabetes or type 2 diabetes on top of treatment. Middle-aged subjects (n 113) of both sexes with pre-diabetes (HbA1c: 5·7-6·4 %) or diabetes (HbA1c ≥ 6·5 %) were randomised to receive nutritional support plus green banana biomass (40 g) (RS: approximately 4·5 g, G1, n 62) or diet alone (G2, n 51) for 24 weeks. Body composition, biochemical analyses and dietary intake were evaluated at the beginning and end of the study. In the experimental group (G1), consumption of RS was associated with reduction in HbA1c (P = 0·0001), fasting glucose (P = 0·021), diastolic blood pressure (P = 0·010), body weight (P = 0·002), BMI (P = 0·006), waist and hip circumferences (P < 0·01), fat mass percentage (P = 0·001) and increase in lean mass percentage (P = 0·011). In controls (G2), reductions were observed in waist and hip circumferences (P < 0·01), HbA1c (P = 0·002) and high-density lipoprotein-cholesterol (P = 0·020). In pre-diabetes or diabetes, non-significant differences were observed in the percentage reduction in HbA1c and fasting glucose in exploratory analyses. Our results indicate that the consumption of bioactive starches is a good dietary strategy to improve metabolic control and body composition.

2.
Clin Lab ; 64(7): 1105-1112, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30146832

RESUMO

BACKGROUND: The use of point-of-care testing (POCT) in different clinical applications is justified by the fact that the time to release the result is shortened, allowing the physician to define the diagnosis and most appropriate therapy in a shorter time. However, the negative aspects must also be highlighted and studied so that we can move forward with the use of these devices. These negative aspects include greater analytical imprecision compared to laboratory automation, the variability between different equipment from different manufacturers, the risk of inappropriate use, a low level of global regulation, higher costs compared with laboratory testing and cost ineffectiveness in terms of health care. Methods and. RESULTS: This review presents some clinical applications of POCT in different scenarios, such as for diabetes mellitus, infectious diseases, pediatrics, and chronic kidney disease, among others. CONCLUSIONS: We hope to see a global consensus on an acceptable quality standard for performing POCT that is adaptable, practical, and cost effective in primary care settings, ensuring patient safety, and minimizing the risk of harm.

3.
J Pediatr Endocrinol Metab ; 31(6): 637-640, 2018 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-29750652

RESUMO

BACKGROUND: Bone metabolism involves many complex pathways that are disturbed by several bone diseases. The literature shows some limitations concerning pediatric reference intervals to bone markers, mainly because of the low number of patients included in the studies, the heterogeneity of methods, beyond the fact that it is time-consuming and expensive. The aim of this study was to determine reference values for ß-isomerized carboxy-terminal telopeptides collagen type I (ß-CTX), a marker of bone resorption, for children and adolescents. METHODS: Blood samples from 246 patients were collected and ß-CTX was measured using an electrochemiluminescence immunoassay (ECLI). RESULTS AND CONCLUSIONS: We propose reference ranges for ß-CTX concentration from the 2.5 percentile and 97.5 percentile for each age group. The reference values obtained, concerning children and adolescents, might be useful in the evaluation of diseases such as osteosarcoma and anorexia in both childhood as adolescence.


Assuntos
Biomarcadores/sangue , Reabsorção Óssea/diagnóstico , Colágeno Tipo I/sangue , Técnicas de Diagnóstico Endócrino/normas , Peptídeos/sangue , Adolescente , Fatores Etários , Reabsorção Óssea/sangue , Criança , Colágeno Tipo I/química , Técnicas Eletroquímicas/normas , Feminino , Humanos , Isomerismo , Medições Luminescentes/normas , Masculino , Peptídeos/química , Valores de Referência
4.
Clin Lab ; 64(1): 1-9, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29479878

RESUMO

Point-of-Care Testing (POCT) has been highlighted in the health care sector in recent decades. On the other hand, due to its low demand, POCT is at a disadvantage compared to conventional equipment, since its cost is inversely proportional to the volume of use. In addition, for the implementation of POCT to succeed, it is essential to rely on the work of a multidisciplinary team. The awareness of health professionals of the importance of each step is perhaps the critical success factor. The trend towards the continuous advancement of the use of POCT and the great potential of its contributions reinforce the need to implement quality management tools, including performance indicators, to ensure their results. This review presents some advantages and disadvantages concerning POCT and the real need to use it. A worldwide call for the availability of easy-to-use health technologies that are increasingly closer to the final user is one of the main reasons for this focus.

5.
Trials ; 18(1): 601, 2017 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-29258572

RESUMO

BACKGROUND: Early reperfusion of the occluded coronary artery during acute myocardial infarction is considered crucial for reduction of infarcted mass and recovery of ventricular function. Effective microcirculation and the balance between protective and harmful lymphocytes may have roles in reperfusion injury and may affect final ventricular remodeling. METHODS/DESIGN: BATTLE-AMI is an open-label, randomized trial comparing the effects of four therapeutic strategies (rosuvastatin/ticagrelor, rosuvastatin/clopidogrel, simvastatin plus ezetimibe/ticagrelor, or simvastatin plus ezetimibe/clopidogrel) on infarcted mass and left ventricular ejection fraction (LVEF) (blinded endpoints) in patients with ST-segment elevation myocardial infarction submitted to fibrinolytic therapy before coronary angiogram (pharmacoinvasive strategy). All patients (n = 300, 75 per arm) will be followed up for six months. The effects of treatment on subsets of B and T lymphocytes will be determined by flow-cytometry/ELISPOT and will be correlated with the infarcted mass, LVEF, and microcirculation perfusion obtained by cardiac magnetic resonance imaging. The primary hypothesis is that the combined rosuvastatin/ticagrelor therapy will be superior to other therapies (particularly for the comparison with simvastatin plus ezetimibe/clopidogrel) for the achievement of better LVEF at 30 days (primary endpoint) and smaller infarcted mass (secondary endpoint) at 30 days and six months. The trial will also evaluate the improvement in the immune/inflammatory responses mediated by B and T lymphocytes. Omics field (metabolomics and proteomics) will help to understand these responses by molecular events. DISCUSSION: BATTLE-AMI is aimed to (1) evaluate the role of subsets of lymphocytes on microcirculation improvement and (2) show how the choice of statin/antiplatelet therapy may affect cardiac remodeling after acute myocardial infarction with ST elevation. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02428374 . Registered on 28 September 2014.


Assuntos
Anti-Inflamatórios/administração & dosagem , Linfócitos B/efeitos dos fármacos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Mediadores da Inflamação/sangue , Inibidores da Agregação de Plaquetas/administração & dosagem , Infarto do Miocárdio com Supradesnível do Segmento ST/tratamento farmacológico , Linfócitos T/efeitos dos fármacos , Terapia Trombolítica , Adenosina/administração & dosagem , Adenosina/análogos & derivados , Anti-Inflamatórios/efeitos adversos , Linfócitos B/imunologia , Linfócitos B/metabolismo , Biomarcadores/sangue , Brasil , Protocolos Clínicos , Clopidogrel , Angiografia Coronária , Quimioterapia Combinada , ELISPOT , Ezetimiba/administração & dosagem , Feminino , Citometria de Fluxo , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Imagem por Ressonância Magnética , Masculino , Metabolômica , Inibidores da Agregação de Plaquetas/efeitos adversos , Proteômica , Projetos de Pesquisa , Rosuvastatina Cálcica/administração & dosagem , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/imunologia , Sinvastatina/administração & dosagem , Volume Sistólico/efeitos dos fármacos , Linfócitos T/imunologia , Linfócitos T/metabolismo , Terapia Trombolítica/efeitos adversos , Ticagrelor , Ticlopidina/administração & dosagem , Ticlopidina/análogos & derivados , Fatores de Tempo , Resultado do Tratamento , Função Ventricular Esquerda/efeitos dos fármacos , Remodelação Ventricular/efeitos dos fármacos
6.
Clin Sci (Lond) ; 131(12): 1215-1224, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-28566450

RESUMO

Monocytes circulate in the blood and migrate to inflammatory tissues, but their functions can be either detrimental or beneficial, depending on their phenotypes. In humans, classical monocytes are inflammatory cluster of differentiation (CD)14++CD16-CCR2++ cells originated from the bone marrow or spleen reservoirs and comprise ≥92% of monocytes. Intermediate monocytes (CD14++CD16+CCR2+) are involved in the production of anti-inflammatory cytokines [such as interleukin (IL)-10], reactive oxygen species (ROS), and proinflammatory mediators [such as tumor necrosis factor-α (TNF-α) and IL-1ß). Nonclassical monocytes (CD14+CD16++CCR2-) are patrolling cells involved in tissue repair and debris removal from the vasculature. Many studies in both humans and animals have shown the importance of monocyte chemoattractant protein-1 (MCP-1) and its receptor [chemokine receptor of MCP-1 (CCR2)] in pathologies, such as atherosclerosis and myocardial infarction (MI). This review presents the importance of these monocyte subsets in cardiovascular diseases (CVDs), and sheds light on new strategies for the blocking of the MCP-1/CCR2 axis as a therapeutic goal for treating vascular disorders.


Assuntos
Doenças Cardiovasculares/metabolismo , Quimiocina CCL2/metabolismo , Monócitos/metabolismo , Receptores CCR2/metabolismo , Animais , Anti-Inflamatórios/uso terapêutico , Fármacos Cardiovasculares/uso terapêutico , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/imunologia , Quimiocina CCL2/antagonistas & inibidores , Humanos , Ligantes , Monócitos/classificação , Monócitos/efeitos dos fármacos , Monócitos/imunologia , Fenótipo , Receptores CCR2/antagonistas & inibidores , Transdução de Sinais
7.
8.
Trials ; 18(1): 601-601, 2017.
Artigo em Inglês | Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: ses-36830

RESUMO

BACKGROUND: Early reperfusion of the occluded coronary artery during acute myocardial infarction is considered crucial for reduction of infarcted mass and recovery of ventricular function. Effective microcirculation and the balance between protective and harmful lymphocytes may have roles in reperfusion injury and may affect final ventricular remodeling. METHODS/DESIGN: BATTLE-AMI is an open-label, randomized trial comparing the effects of four therapeutic strategies (rosuvastatin/ticagrelor, rosuvastatin/clopidogrel, simvastatin plus ezetimibe/ticagrelor, or simvastatin plus ezetimibe/clopidogrel) on infarcted mass and left ventricular ejection fraction (LVEF) (blinded endpoints) in patients with ST-segment elevation myocardial infarction submitted to fibrinolytic therapy before coronary angiogram (pharmacoinvasive strategy). All patients (n = 300, 75 per arm) will be followed up for six months. The effects of treatment on subsets of B and T lymphocytes will be determined by flow-cytometry/ELISPOT and will be correlated with the infarcted mass, LVEF, and microcirculation perfusion obtained by cardiac magnetic resonance imaging. The primary hypothesis is that the combined rosuvastatin/ticagrelor therapy will be superior to other therapies (particularly for the comparison with simvastatin plus ezetimibe/clopidogrel) for the achievement of better LVEF at 30 days (primary endpoint) and smaller infarcted mass (secondary endpoint) at 30 days and six months...(AU)


Assuntos
Infarto do Miocárdio , Linfócitos B , Espectroscopia de Ressonância Magnética , Metabolômica , Proteômica
9.
Crit Rev Eukaryot Gene Expr ; 26(2): 161-2, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27480778

RESUMO

The paper summarizes the difficulties to study the rare population of endothelial progenitor cells in clinical trials, based on the experience of our group in many publications in this area.


Assuntos
Células Progenitoras Endoteliais , Transplante de Células-Tronco/métodos , Ensaios Clínicos como Assunto , Humanos
10.
J Clin Lipidol ; 9(4): 542-52, 2015 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26228672

RESUMO

OBJECTIVE: Plant sterol (PS) supplementation has been widely used alone or combined with lipid-lowering therapies (LLTs) to reduce low-density lipoprotein (LDL) cholesterol. The effects of PS added to high-intensity LLT are less reported, especially regarding the effects on cholesterol synthesis and absorption. METHODS: A prospective, randomized, open-label study, with parallel arms and blinded end points was designed to evaluate the effects of addition of PS to LLT on LDL cholesterol, markers of cholesterol synthesis, and absorption. Eighty-six patients of both genders were submitted to a 4-wk run-in period with atorvastatin 10 mg (baseline). Following, subjects received atorvastatin 40 mg, ezetimibe 10 mg, or combination of both drugs for another 4-wk period (phase I). In phase II, capsules containing 2.0 g of PSs were added to previous assigned treatments for 4 wk. Lipids, apolipoproteins, plasma campesterol, ß-sitosterol, and desmosterol levels were assayed at all time points. Within and between-group analyses were performed. RESULTS: Compared with baseline, atorvastatin 40 mg reduced total and LDL cholesterol (3% and 22%, respectively, P < .05), increased ß-sitosterol, campesterol/cholesterol, and ß-sitosterol/cholesterol ratios (39%, 47%, and 32%, respectively, P < .05); ezetimibe 10 mg reduced campesterol and campesterol/cholesterol ratio (67% and 70%, respectively, P < .05), and the combined therapy decreased total and LDL cholesterol (22% and 38%, respectively, P < .05), campesterol, ß-sitosterol, and campesterol/cholesterol ratio (54%, 40%, and 27%, P < .05). Addition of PS further reduced total and LDL cholesterol by ∼ 7.7 and 6.5%, respectively, in the atorvastatin therapy group and 5.0 and 4.0% in the combined therapy group (P < .05, for all), with no further effects in absorption or synthesis markers. CONCLUSIONS: PS added to LLT can further improve lipid profile, without additional effects on intestinal sterol absorption or synthesis.


Assuntos
Anticolesterolemiantes/administração & dosagem , Suplementos Nutricionais , Hipercolesterolemia/tratamento farmacológico , Fitosteróis/administração & dosagem , Idoso , Apolipoproteínas/sangue , Atorvastatina/administração & dosagem , Colesterol/análogos & derivados , Colesterol/sangue , LDL-Colesterol/sangue , Sinergismo Farmacológico , Ezetimiba/administração & dosagem , Ezetimiba/efeitos adversos , Feminino , Humanos , Hipercolesterolemia/sangue , Metabolismo dos Lipídeos/efeitos dos fármacos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fitosteróis/efeitos adversos , Fitosteróis/sangue , Sitosteroides/sangue
11.
Life Sci ; 92(14-16): 845-51, 2013 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-23507424

RESUMO

AIMS: High-risk subjects with elevated C-reactive protein (CRP) are at high risk for cardiovascular events and frequently require potent statins or combined lipid-lowering therapy to achieve lipid targets and decrease inflammation. Our study aimed at evaluating the effects of three lipid-modifying therapies on LDL-cholesterol, CRP levels and markers of cholesterol absorption and synthesis. MAIN METHODS: A prospective intervention study was performed in high cardiovascular risk individuals receiving atorvastatin 10mg daily for four weeks. Those with CRP≥2.0mg/L were randomized to another four-week treatment period with atorvastatin 40mg, ezetimibe 10mg or the combination of atorvastatin 40mg / ezetimibe 10mg. Lipids, markers of cholesterol absorption (campesterol and ß-sitosterol), and synthesis (desmosterol), as well as CRP were quantified at baseline and end of study. KEY FINDINGS: One hundred and twenty two individuals were included. Atorvastatin alone or combined with ezetimibe reduced both LDL-cholesterol and CRP (P<0.002 vs. baseline; Wilcoxon); ezetimibe did not modify CRP. Ezetimibe-based therapies reduced absorption markers and their ratios to cholesterol (P<0.0001 vs. baseline, for all; Wilcoxon), whereas atorvastatin alone increased campesterol/cholesterol and ß-sitosterol/cholesterol ratios (P<0.05 vs. baseline; Wilcoxon). In addition, ezetimibe also increased desmosterol and desmosterol/cholesterol ratio (P<0.0001 vs. baseline; Wilcoxon). SIGNIFICANCE: These results contribute to understanding the link between cellular cholesterol homeostasis, inflammation and lipid-modifying therapies. Our findings highlight the broader benefit of combined therapy with a potent statin and ezetimibe decreasing inflammation, and preventing increase in cholesterol biosynthesis, an effect not observed with ezetimibe alone.


Assuntos
Anticolesterolemiantes/farmacologia , Azetidinas/farmacologia , Proteína C-Reativa/metabolismo , Colesterol/metabolismo , Ácidos Heptanoicos/farmacologia , Pirróis/farmacologia , Idoso , Atorvastatina , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Colesterol/análogos & derivados , Colesterol/biossíntese , Desmosterol/metabolismo , Ezetimiba , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Inflamação/tratamento farmacológico , Inflamação/patologia , Masculino , Pessoa de Meia-Idade , Fitosteróis/metabolismo , Estudos Prospectivos , Fatores de Risco , Sitosteroides/metabolismo , Estatísticas não Paramétricas
13.
Circ J ; 76(3): 729-36, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22214900

RESUMO

BACKGROUND: Increased numbers of endothelial (EMP) and platelet (PMP) microparticles have been related to cardiovascular risk factors and coronary artery disease. Little is known about the early effects of statins and clopidogrel on these new biomarkers of vascular homeostasis. The aim of the present study was to evaluate pharmacokinetic interactions between atorvastatin and clopidogrel and their effects, alone or combined, on EMP, PMP, and endothelial progenitor cells (EPC). METHODS AND RESULTS: A prospective open-label study enrolled subjects with stable coronary disease (n=26). Drugs were given daily for 3 weeks (atorvastatin 80 mg, visits 1-3; clopidogrel 75 mg, visits 2-4). Counts of EPC (CD34+/CD133+/KDR+), EMP (CD51+) and PMP (CD42+/CD31+), and pharmacokinetic parameters over 24h were assessed at each visit. Atorvastatin plasma concentrations were increased by concomitant therapy with clopidogrel (maximum serum concentration [C(max)], P=0.002; area under the clopidogrel or atorvastatin plasma concentration vs. time curve from 0 to the last detectable concentration [AUC(last)], P=0.03). After atorvastatin withdrawal there was an increase in clopidogrel plasma concentrations (C(max), P=0.009; AUC(last), P=0.039). PMP were inversely correlated with clopidogrel C(max) on visit 3 (rho=-0.57, P=0.006) and on visit 4 (rho=-0.54, P=0.01), and with clopidogrel AUC(last) on visit 3 (rho=-0.44, P=0.04), and on visit 4 (rho=-0.57, P=0.005). In addition, clopidogrel C(max) was correlated with EPC (CD133+/KDR+) on visit 4 (rho=0.48, P=0.025). No correlations of atorvastatin and MP or EPC were found. CONCLUSIONS: The balance between platelet MP release and EPC mobilization seems influenced by clopidogrel plasma levels, suggesting a protective mechanism on coronary artery disease.


Assuntos
Plaquetas/patologia , Doença da Artéria Coronariana/tratamento farmacológico , Células Endoteliais/patologia , Células-Tronco/patologia , Ticlopidina/análogos & derivados , Adulto , Idoso , Movimento Celular , Micropartículas Derivadas de Células/efeitos dos fármacos , Clopidogrel , Doença da Artéria Coronariana/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação de Plaquetas , Substâncias Protetoras , Antagonistas do Receptor Purinérgico P2Y , Ticlopidina/sangue , Ticlopidina/farmacologia
14.
AIDS ; 25(13): 1595-601, 2011 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-21673561

RESUMO

BACKGROUND: Cardiovascular events have been reported among HIV-infected patients following antiretroviral therapy. However, the role of HIV itself in determining vascular damage is less described. Chronic inflammatory state might impair some regulatory endothelium properties leading to its activation, apoptosis or erosion. OBJECTIVES: To evaluate the balance between endothelial progenitor cells and microparticles in HIV-infected antiretroviral drug-naive patients. DESIGN: A case-control study comparing HIV-infected patients (n = 35) with sex-matched and age-matched healthy controls (n = 33). METHODS: Endothelial progenitor cells populations expressing CD34, CD133 and KDR were quantified by flow cytometry. Endothelial-derived microparticles, expressing CD51, and platelet-derived microparticles, expressing CD31/CD42, were also measured. Endothelial function was estimated by flow-mediated dilation. RESULTS: Lower percentages of endothelial progenitor cells (CD34/KDR) were observed in HIV-infected individuals compared with controls (0.02 vs. 0.09%, P = 0.045). In addition, endothelial microparticles concentration was higher in HIV-infected individuals (1963 vs. 436 microparticles/µl platelet-poor plasma, P = 0.003), with similar number of platelet-derived microparticles among groups. Furthermore, flow-mediated dilation was lower among HIV-infected individuals compared with controls [mean (SEM): 10 (1) and 16% (2), respectively; P = 0.03]. CONCLUSION: Our findings suggest an imbalance between endothelial progenitor cells mobilization and endothelial apoptosis. The alteration in the turnover of endothelial cells may contribute to cardiovascular events in HIV-infected patients.


Assuntos
Micropartículas Derivadas de Células/metabolismo , Células Endoteliais/metabolismo , Endotélio Vascular/fisiopatologia , Infecções por HIV/fisiopatologia , Células-Tronco/metabolismo , Antígeno AC133 , Adulto , Antígenos CD/metabolismo , Antígenos CD34/metabolismo , Apoptose , Brasil , Estudos de Casos e Controles , Endotélio Vascular/metabolismo , Feminino , Citometria de Fluxo , Glicoproteínas/metabolismo , Infecções por HIV/metabolismo , Humanos , Integrina alfaV/metabolismo , Masculino , Pessoa de Meia-Idade , Peptídeos/metabolismo , Molécula-1 de Adesão Celular Endotelial a Plaquetas/metabolismo , Complexo Glicoproteico GPIb-IX de Plaquetas/metabolismo , Estudos Prospectivos , Vasodilatação , Adulto Jovem
15.
Rev. neurol. (Ed. impr.) ; 51(9): 551-560, 1 nov., 2010. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-87335

RESUMO

Resumen. Como la esperanza de vida media de los seres humanos está aumentando en todo el mundo, el accidente cerebrovascular isquémico se ha convertido en una de las causas más importantes de morbimortalidad, especialmente en los países emergentes. Se ha establecido un descenso significativo en las tasas del primer accidente cerebrovascular y del accidente cerebrovascular recurrente con el uso de estatinas en ensayos clínicos grandes y en metaanálisis y revisiones sistemáticas. Curiosamente, los estudios de observación describieron que los niveles de colesterol estaban sólo débilmente asociados al accidente cerebrovascular isquémico, lo que sugiere que debe haber otros posibles mecanismos implicados en la protección vascular. De hecho, más allá de los cambios en los lípidos, se han propuesto algunas propiedades de estos medicamentos relativas a la inflamación, hemostasia, función endotelial, estabilización de las placas de ateroma y, más recientemente, a la movilización de las células endoteliales. Asimismo, un metaanálisis reciente también puso de manifiesto que las estatinas reducen la presión arterial sistólica y diastólica. En general, todos estos beneficios pueden contribuir a la prevención de los accidentes cerebrovasculares mediante el uso de estatinas (AU)


Summary. As the average human lifespan is increasing worldwide, ischemic stroke became one of the most important causes of mortality and morbidity, particularly in emerging countries. Significant decrease in the rates of first and recurrent stroke using statins has been established in large clinical trials and in systematic reviews and meta-analyses. Interestingly, observational studies reported that cholesterol levels were only weakly associated with ischemic stroke, suggesting that other potential mechanisms for vascular protection should be implicated. Indeed, beyond lipid changes, some properties of these drugs, related to inflammation, hemostasis, endothelial function, plaque stabilization, and more recently, to the mobilization of endothelial cells, have been proposed. In addition, recent meta-analysis also revealed that statins decrease systolic and diastolic blood pressure. Taken together, all these benefits can contribute for stroke prevention by statins (AU)


Assuntos
Humanos , /farmacocinética , Acidente Vascular Cerebral/prevenção & controle , Células Endoteliais , Hemostasia , Pressão Sanguínea
16.
Rev Neurol ; 51(9): 551-60, 2010 Nov 01.
Artigo em Espanhol | MEDLINE | ID: mdl-20979035

RESUMO

As the average human lifespan is increasing worldwide, ischemic stroke became one of the most important causes of mortality and morbidity, particularly in emerging countries. Significant decrease in the rates of first and recurrent stroke using statins has been established in large clinical trials and in systematic reviews and meta-analyses. Interestingly, observational studies reported that cholesterol levels were only weakly associated with ischemic stroke, suggesting that other potential mechanisms for vascular protection should be implicated. Indeed, beyond lipid changes, some properties of these drugs, related to inflammation, hemostasis, endothelial function, plaque stabilization, and more recently, to the mobilization of endothelial cells, have been proposed. In addition, recent meta-analysis also revealed that statins decrease systolic and diastolic blood pressure. Taken together, all these benefits can contribute for stroke prevention by statins.


Assuntos
Isquemia Encefálica/prevenção & controle , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Acidente Vascular Cerebral/prevenção & controle , Pressão Sanguínea/efeitos dos fármacos , Ensaios Clínicos como Assunto , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Metanálise como Assunto , Fatores de Risco
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