Estudio del perfil lipídico y del grosor íntima--media de la carótida en pacientes en hemodiálisis (HD) tratados con atorvastatina

Resumen

Introduction. Is well known that treatment with statins, not only reduces cholesterol plasmatic level, but improves patient morbi-mortality. Statins reduces risk for acute cerebrovascular events and improves progression of atherosclerosis. The measurement of intima-media thickness on carotid artery have been shown a predictor of cardio-vascular and cerebrovascular events. Moreover, it has been reported that an association exist between total plasmatic cholesterol level and carotid artery atherosclerosis. Also, it have been reported that treatment with pravastatin and atorvastatin diminish common carotid artery intima-media thickness. Patients and methods. 15 hemodialysis patients with arteriosclerosis has been studied, divided in two groups: A, 8 patients with serum lipidic changes, and B, 7 patients without lipidic changes. Both groups were treated with atorvastatin on a 40 mg/day oral dose during a year. In both groups were determinated plasma total cholesterol, triglycerides, HDLcholesterol, LDL-cholesterol, and plasmatic homocysteine level, at the beginning, 6 month and 12 month of start study. At study onset and 12 month, measurement on common carotid artery intima-media thickness was made by doppler-ultrasonography. Results. In both groups, cholesterol and LDL-cholesterol values shows a significant decrease (p < 0,005) at 6 and 12 months relate to basal values. Triglyceride levels and HDL-cholesterol decrease alone the year, but not in a significant form. Plasmatic homocysteine raise during the study, but not in a significant form. Carotid artery mio-intimal (intima-media) thickness decrease, from its basal level to 12 month, in a significant form (p < 0,005). Conclusions. Treatment with oral atorvastatin, on a 40 mg/day schedule, significantly reduces carotid artery intima-media thickness, with a clear benefit for atherosclerotic patients on HD. Also, there are a significant decrease in cholesterol and LDL-cholesterol levels in those patients.