Tratamiento hipolipemiante en la era COVID-19

  1. M. Frías Vargas 1
  2. A. Díaz Rodríguez 2
  3. B. Díaz Fernández 3
  1. 1 Centro de Salud Comillas, Madrid, España
  2. 2 Centro de Salud de Bembibre, Bembibre, León, España
  3. 3 Universidad de Salamanca, Salamanca, España
Mostrar afiliaciones +
Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Año de publicación: 2020

Número: 7

Páginas: 497-502

Tipo: Artículo

DOI: 10.1016/J.SEMERG.2020.06.014 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Semergen: revista española de medicina de familia

Resumen

Antecedentes y objetivos La pandemia por COVID-19 ha puesto de manifiesto que las enfermedades cardiovasculares conllevan mayor riesgo de mortalidad. Han surgido dudas en cuanto a la terapia lipídica en estos pacientes. Nuestro objetivo en esta revisión es analizar la eficacia y la seguridad de la terapia hipolipemiante en los pacientes con COVID-19. Material y métodos Se realizó una revisión de la literatura científica en PubMed, informes CDC, NIH y NCBI SARS-CoV-2 utilizando las palabras clave: COVID-19, statins, ezetimibe, PCSK9 inhibitors, hypercholesterolemia and hypolipidemic drugs. Resultados Las estatinas se deben seguir utilizando en los pacientes con COVID-19 en base a su eficacia, seguridad, efectos inmunosupresores, antiinflamatorios, disponibilidad y accesibilidad. En función de los niveles de riesgo cardiovascular de estos pacientes puede ser necesario el empleo de estatinas de alta potencia y/o ezetimiba y/o inhibidores de la proproteína convertasa subtilisina (iPCSK9) en pacientes de alto y muy alto riesgo cardiovascular. Los pacientes tratados con iPCSK9 deben seguir con el tratamiento por sus efectos beneficiosos sobre la prevención de la enfermedad cardiovascular. Los pacientes con hipercolesterolemia familiar y COVID-19 son especialmente vulnerables a la enfermedad cardiovascular precoz y deben seguir recibiendo el tratamiento hipolipemiante intensivo. Conclusiones En los pacientes con COVID-19 la mayoría de las enfermedades cardiovasculares basales son de origen aterosclerótico, con peor pronóstico para los pacientes con alto riesgo y muy alto riesgo de enfermedad cardiovascular. En estos pacientes el tratamiento intensivo con estatinas y/o combinación fija con ezetimiba y/o iPCSK9 juega un papel fundamental.

Referencias bibliográficas

  • H.K. Siddiqi, M.R. Mehra COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal J Heart Lung Transplant, 39 (2020), pp. 405-407 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • D. Wang, B. Hu, C. Hu, F. Zhu, X. Liu, J. Zhang, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China J Am Med Assoc, 323 (2020), pp. 1061-1069, 10.1001/jama.2020.1585 CrossRefView Record in ScopusGoogle Scholar
  • S. Shi, M. Qin, B. Shen, Y. Cai, T. Liu, F. Yang, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China J Am Med Assoc Cardiol (2020), 10.1001/jamacardio.2020.0950 Google Scholar
  • T. Guo, Y. Fan, M. Chen, X. Wu, L. Zhang, T. He, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19) J Am Med Assoc Cardiol (2020), 10.1001/jamacardio.2020.1017 Google Scholar
  • J. Fan, H. Wang, G. Ye, X. Cao, X. Xu, W. Tan, et al. Letter to the Editor: Low-density lipoprotein is a potential predictor of poor prognosis in patients with coronavirus disease 2019 Metabolism., 107 (2020), pp. 154-243, 10.1016/j.metabol.2020.154243 CrossRefView Record in ScopusGoogle Scholar
  • M.R. Mehra, S.S. Desai, S. Kuy, T.D. Henry, A.N. Patel Cardiovascular disease drug therapy, and mortality in Covid-19 N Engl J Med (2020), 10.1056/NEJMoa2007621 Google Scholar
  • M.R. Mehra, S.S. Desai Retraction: Cardiovascular disease drug therapy, and mortality in Covid-19 N Engl J Med (2020), 10.1056/NEJMoa2007621 Google Scholar
  • V. Castiglione, M. Chiriacò, M. Emdin, S. Taddei, G. Vergaro. Statin therapy in COVID-19 infection, European Heart Journal Cardiovascular Pharmacotherapy, pvaa042. Disponible en: https://doi.org/10.1093/ehjcvp/pvaa042 Google Scholar
  • H. Guo, M. Huang, Q. Yuan, Y. Wei, Y. Gao, L. Mao, et al. The important role of lipid raft-mediated attachment in the infection of cultured cells by coronavirus infectious bronchitis virus Beaudette strain PLoS One., 12 (2017), p. e0170123, 10.1371/journal.pone.0170123 CrossRefGoogle Scholar
  • J.H. Jeon, C. Lee Cholesterol is important for the entry process of porcine deltacoronavirus Arch Virol., 163 (2018), pp. 3119-3124 CrossRefView Record in ScopusGoogle Scholar
  • M.H.M. Yousif, G.S. Dhaunsi, B.M. Makki, B.A. Qabazard, S. Akhtar, I.F. Benter Characterization of angiotensin-(1-7) effects on the cardiovascular system in an experimental model of type-1 diabetes Pharmacol Res, 66 (2012), pp. 269-275, 10.1016/j.phrs.05.0012012 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • A.L. Totura, A. Whitmore, S. Agnihothram, A. Schäfer, M.G. Katze, M.T. Heise, et al. Toll-like receptor 3 signaling via TRIF contributes to a protective innate immune response to severe acute respiratory syndrome coronavirus infection mBio, 6 (2015), pp. e00638-e715, 10.1128/mBio.00638-15 Google Scholar
  • A.M. South, D.I. Diz, M.C. Chappell COVID-19 ACE2, and the cardiovascular consequences Am J Physiol Heart Circ Physiol., 318 (2020), pp. H1084-H1090 CrossRefView Record in ScopusGoogle Scholar
  • K. Tikoo, G. Patel, S. Kumar, P.A. Karpe, M. Sanghavi, V. Malek, et al. Tissue specific up regulation of ACE2 in rabbit model of atherosclerosis by atorvastatin: role of epigenetic histone modifications Biochem Pharmacol, 93 (2015), pp. 343-351, 10.1016/j.bcp.11.0132014 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • Y.H. Shin, J.J. Min, J.H. Lee, E.H. Kim, G.E. Kim, M.H. Kim, et al. The effect of fluvastatin on cardiac fibrosis and angiotensin-converting enzyme-2 expression in glucose-controlled diabetic rat hearts Heart Vessels, 32 (2017), pp. 618-627, 10.1007/s00380-016-50936 CrossRefView Record in ScopusGoogle Scholar
  • Z. Reiner, M. Hatamipour, M. Banach Statins and the COVID-19 main protease: In silico evidence on direct interaction Arch Med Sci., 16 (2020), pp. 490-496 CrossRefView Record in ScopusGoogle Scholar
  • R. Zeiser Immune modulatory effects of statins Immunology, 154 (2018), pp. 69-75 View Record in ScopusGoogle Scholar
  • M. Pirro, L.E. Simental-Mendia, V. Bianconi, G.F. Watts, M. Banach, A. Sahebkar Effect of statin therapy on arterial wall inflammation based on 18F-FDG PET/CT: A systematic review and meta-analysis of interventional studies Clin Med, 8 (2019), p. E118 Google Scholar
  • A. Bahrami, N. Parsamanesh, S.L. Atkin, M. Banach, A. Sahebkar Effect of statins on toll-like receptors: A new insight to pleiotropic effects Pharmacol Res, 135 (2018), pp. 230-238 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • S.P. Parihar, R. Guler, F. Brombacher Statins: A viable candidate for host-directed therapy against infectious diseases Nat Rev Immunol, 19 (2019), pp. 104-117 CrossRefView Record in ScopusGoogle Scholar
  • M. Madjid, P. Safavi-Naeini, S.D. Solomon, O. Vardeny Potential effects of coronaviruses on the cardiovascular system: A review J Am Med Assoc Cardiol (2020), 10.1001/jamacardio.2020.1286 Google Scholar
  • T. Yoshida, M. Hayashi Pleiotropic effects of statins on acute kidney injury: Involvement of Krüppel-like factor 4 Clin Exp Nephrol, 21 (2017), pp. 175-181 CrossRefView Record in ScopusGoogle Scholar
  • T. Guo, Y. Fan, M. Chen, X. Wu, L. Zhang, T. He, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19) J Am Med Assoc Cardiol (2020), 10.1001/jamacardio.2020.1017 Google Scholar
  • M. Banach, T. Stulc, R. Dent, P.P. Toth Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement Int J Cardiol, 225 (2016), pp. 184-196 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • M. Banach, P.E. Penson What have we learned about lipids and cardiovascular risk from PCSK9 inhibitor outcome trials: ODYSSEY and FOURIER? Cardiovasc Res, 115 (2019), pp. e26-e31 CrossRefGoogle Scholar
  • F. Mach, C. Baigent, A.L. Catapano, K.C. Koskinas, M. Casula, L. Badimon, et al., ESC Scientific Document Group 2019 ESC/EAS Guidelines for the management of dyslipidemias: Lipid modification to reduce cardiovascular risk Eur Heart J, 41 (2020), pp. 111-188 CrossRefView Record in ScopusGoogle Scholar
  • P.M. Ridker Clinician's guide to reducing inflammation to reduce atherothrombotic risk: JACC Review Topic of the Week J Am Coll Cardiol, 72 (2018), pp. 3320-3331 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • A.A. Momtazi-Borojeni, S. Sabouri-Rad, A.M. Gotto PCSK9 and inflammation: A review of experimental and clinical evidence Eur Heart J Cardiovasc Pharmacother, 5 (2019), pp. 237-245 CrossRefView Record in ScopusGoogle Scholar
  • F. Khademi, A.A. Momtazi-Borojeni, Z. Reiner, M. Banach, K.A. al-Rasadi, A. Sahebkar PCSK9 and infection: A potentially useful or dangerous association? J Cell Physiol, 233 (2018), pp. 2920-2927 CrossRefGoogle Scholar
  • A. Vuorio, G.F. Watts, W.J. Schneider, S. Tsimikas, P.T. Kovanen Familial hypercholesterolemia and elevated lipoprotein(a): Double heritable risk and new therapeutic opportunities J Int Med, 287 (2020), pp. 2-18 CrossRefView Record in ScopusGoogle Scholar
  • N. Katsiki, M. Banach, D.P. Mikhailidis Lipid lowering therapy and renin-angiotensin-aldosterone system inhibitors in the era of the COVID-19 pandemic Arch Med Sci, 16 (2020), pp. 485-489 CrossRefView Record in ScopusGoogle Scholar
  • E. Driggin, M.V. Madhavan, B. Bikdeli, T. Chuich, J. Laracy, G. Bondi-Zoccai, et al. Cardiovascular considerations for patients health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic J Am Coll Cardiol (2020), 10.1016/j.jacc.2020.03.031 Google Scholar
  • Stockley's Drug Interactions: azithromycin and statins interactions [consultado 13 May 2020]. Disponible en: https://about.medicinescomplete.com/publication/stockleys-interactions-checker/ Google Scholar
  • R.S. Rosenson, S. Baker, M. Banach Optimizing cholesterol treatment in patients with muscle complaints J Am Coll Cardiol, 70 (2017), pp. 1290-1301 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • https://www.ema.europa.eu/en/documents/other/conditions-use-conditions-distribution-patients-targeted-conditions-safety-monitoring-adressed_en-2.pdf. (Acceso on line el 13 de May 2020). Google Scholar
  • [consultado 13 May 2020]. Disponible en: https://www.ema.europa.eu/en/documents/product-information/roactemra-epar-product-information_en.pdf Google Scholar
  • M. Banach, P.E. Penson, Z. Fras, M. Vrablik, D. Pella, Z. Reiner, et al., FH Europe and the International Lipid Expert Panel (ILEP) Brief recommendations on the management of adult patients with familial hypercholesterolemia during the COVID-19 pandemic Pharmacol Res, 7 (2020), p. 104891, 10.1016/j.phrs.2020.91 1048 ArticleDownload PDFGoogle Scholar
  • R. Scicali, A. Di Pino, S. Piro, A.M. Rabuazzo, F. Purrello May statins and PCSK9 inhibitors be protective from COVID-19 in familial hypercholesterolemia subjects? Nutr Metab Cardiovasc Dis (2020), 10.1016/j.numecd.05.0032020 Google Scholar
Fuente de los datos: Dialnet