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      OMACOR® (Una formulación concentrada de Ácidos Omega 3), en el tratamiento de los triglicéridos elevados Translated title: OMACOR ® (A concentrated formulation Omega 3 Acid) in the treatment of high triacylglycerols

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          Abstract

          Antecedentes: La hiperlipidemia es una condición clínica frecuente que favorece el desarrollo de ateroesclerosis. Los triglicéridos (TG) son considerados un factor muy importante en esto. Los ácidos grasos n-3 reducen los triglicéridos y están asociados con menor riesgo de muerte súbita en pacientes post infarto del miocardio, protección que podría ser efectiva en pacientes sin evidencia de enfermedad previa. Métodos: Estudio prospectivo de Farmacovigilancia, abierto, multicéntrico, nacional, para evaluar eficacia de Omacor® en reducir hipertrigliceridemia. Después de cuatro semanas de dieta, se evaluó perfil lipídico en ayuno (TG, Colesterol total, LDL-C, VLDL-C, HDL-C, Colesterol no HDL) así como Glicemia, AST y ALT. Aquel paciente que continuaba con triglicéridos mayores a 150 mg por dL, pasaba a la siguiente fase del estudio, que consistía en el suministro de Omacor®, un gramo vía oral, BID, durante 6 semanas. Resultados: Se analizaron por intención a tratar 185 pacientes. Con Omacor® se reportó un descenso significativo en Peso, IMC, PAD y PAS (p<0.001). El tratamiento redujo en forma significativa todas las variables lipídicas en estudio (CT, HTG, LDL-C, No-HDL-C; p<0.001) con un incremento del C-HDL (p 0.002). La HTG se redujo 33% (p<0.001) y el No-HDL-C, 14% (p<0.001). Al final, 59,77% de los pacientes logró estar en meta (TG<150 mg/dL), con Omacor® y dieta, en comparación a 4.47% con dieta. Conclusiones: La administración de Omacor® durante seis semanas en pacientes con HTG resultó segura, con un descenso significativo de todas las variables lipídicas y glicemia.

          Translated abstract

          Background: Hyperlipidemia is a common condition that promotes atherosclerosis development. Triglycerides are being considered a very important factor. n-3 fatty acids lower triglycerides and have been associated with lower risk of sudden death in patients with myocardial infarction and could be effective in patients without evidence of prior cardiovascular disease. Methods: We performed a prospective, open, multicenter, pharmacovigilance study, to evaluate Omacor® effectiveness in reducing triglyceride levels. After four weeks with patients underwent diet, we made lipid profile in fasting, measuring triglycerides, total cholesterol, LDL-C, VLDL-C, HDL-C, Non- HDL-C and glucose, AST and ALT. Patient who continued triglycerides above 150 mg/dL were passed to next phase of study with Omacor®, 1 gr orally, BID for 6 weeks. Results: 185 patients were analyzed by ITT. Treatment with Omacor® reported a significant decrease in weight, BMI, DBP and SBP (p<0.001). In this study, the effect of treatment significantly reduced all lipid variables studied (CT, HTG, LDL-C, non-HDL-C; p<0.001) with an increase in HDL-C (p 0.002). HTG was reduced by 33% (p<0.001) and non-HDL-C 14% (p<0.001). After treatment, 59.77% achieved with diet plus Omacor® the target of TG<150mg/dL compared with the 4.47% only diet. Conclusions: The administration of Omacor® for six weeks in patients with HTG was safe, with a significant decrease in all lipid and glycemic variables.

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          Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.

          A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used.
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            Major lipids, apolipoproteins, and risk of vascular disease.

            Associations of major lipids and apolipoproteins with the risk of vascular disease have not been reliably quantified. To assess major lipids and apolipoproteins in vascular risk. Individual records were supplied on 302,430 people without initial vascular disease from 68 long-term prospective studies, mostly in Europe and North America. During 2.79 million person-years of follow-up, there were 8857 nonfatal myocardial infarctions, 3928 coronary heart disease [CHD] deaths, 2534 ischemic strokes, 513 hemorrhagic strokes, and 2536 unclassified strokes. Hazard ratios (HRs), adjusted for several conventional factors, were calculated for 1-SD higher values: 0.52 log(e) triglyceride, 15 mg/dL high-density lipoprotein cholesterol (HDL-C), 43 mg/dL non-HDL-C, 29 mg/dL apolipoprotein AI, 29 mg/dL apolipoprotein B, and 33 mg/dL directly measured low-density lipoprotein cholesterol (LDL-C). Within-study regression analyses were adjusted for within-person variation and combined using meta-analysis. The rates of CHD per 1000 person-years in the bottom and top thirds of baseline lipid distributions, respectively, were 2.6 and 6.2 with triglyceride, 6.4 and 2.4 with HDL-C, and 2.3 and 6.7 with non-HDL-C. Adjusted HRs for CHD were 0.99 (95% CI, 0.94-1.05) with triglyceride, 0.78 (95% CI, 0.74-0.82) with HDL-C, and 1.50 (95% CI, 1.39-1.61) with non-HDL-C. Hazard ratios were at least as strong in participants who did not fast as in those who did. The HR for CHD was 0.35 (95% CI, 0.30-0.42) with a combination of 80 mg/dL lower non-HDL-C and 15 mg/dL higher HDL-C. For the subset with apolipoproteins or directly measured LDL-C, HRs were 1.50 (95% CI, 1.38-1.62) with the ratio non-HDL-C/HDL-C, 1.49 (95% CI, 1.39-1.60) with the ratio apo B/apo AI, 1.42 (95% CI, 1.06-1.91) with non-HDL-C, and 1.38 (95% CI, 1.09-1.73) with directly measured LDL-C. Hazard ratios for ischemic stroke were 1.02 (95% CI, 0.94-1.11) with triglyceride, 0.93 (95% CI, 0.84-1.02) with HDL-C, and 1.12 (95% CI, 1.04-1.20) with non-HDL-C. Lipid assessment in vascular disease can be simplified by measurement of either total and HDL cholesterol levels or apolipoproteins without the need to fast and without regard to triglyceride.
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              Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis.

              Epidemiological and clinical evidence suggests that an increased intake of long-chain n-3 fatty acids protects against mortality from coronary artery disease. We aimed to test the hypothesis that long-term use of eicosapentaenoic acid (EPA) is effective for prevention of major coronary events in hypercholesterolaemic patients in Japan who consume a large amount of fish. 18 645 patients with a total cholesterol of 6.5 mmol/L or greater were recruited from local physicians throughout Japan between 1996 and 1999. Patients were randomly assigned to receive either 1800 mg of EPA daily with statin (EPA group; n=9326) or statin only (controls; n=9319) with a 5-year follow-up. The primary endpoint was any major coronary event, including sudden cardiac death, fatal and non-fatal myocardial infarction, and other non-fatal events including unstable angina pectoris, angioplasty, stenting, or coronary artery bypass grafting. Analysis was by intention-to-treat. The study was registered at ClinicalTrials.gov, number NCT00231738. At mean follow-up of 4.6 years, we detected the primary endpoint in 262 (2.8%) patients in the EPA group and 324 (3.5%) in controls-a 19% relative reduction in major coronary events (p=0.011). Post-treatment LDL cholesterol concentrations decreased 25%, from 4.7 mmol/L in both groups. Serum LDL cholesterol was not a significant factor in a reduction of risk for major coronary events. Unstable angina and non-fatal coronary events were also significantly reduced in the EPA group. Sudden cardiac death and coronary death did not differ between groups. In patients with a history of coronary artery disease who were given EPA treatment, major coronary events were reduced by 19% (secondary prevention subgroup: 158 [8.7%] in the EPA group vs 197 [10.7%] in the control group; p=0.048). In patients with no history of coronary artery disease, EPA treatment reduced major coronary events by 18%, but this finding was not significant (104 [1.4%] in the EPA group vs 127 [1.7%] in the control group; p=0.132). EPA is a promising treatment for prevention of major coronary events, and especially non-fatal coronary events, in Japanese hypercholesterolaemic patients.
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                Author and article information

                Journal
                avft
                Archivos Venezolanos de Farmacología y Terapéutica
                AVFT
                Sociedad Venezolana de Farmacológia y Farmacológia Clínica y Terapéutica. Escuela de Medicina; José Maria Vargas. Cátedra de Farmacológia, piso 3, esquina san jacinto, San José Caracas (Caracas, DF, Venezuela )
                0798-0264
                March 2014
                : 33
                : 1
                : 13-19
                Article
                S0798-02642014000100003 S0798-0264(14)03300100003
                1a952dfc-5854-47cc-a495-e58e6c0448a8

                http://creativecommons.org/licenses/by/4.0/

                History
                : 21 November 2013
                : 20 October 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 7
                Product

                SciELO Venezuela

                Categories
                Trabajos Originales

                Omacor®,Triglicéridos,Ácidos Omega 3,Triglycerides,Omega 3 fatty acids

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