Palacio-Portilla E J, Roquer J, Amaro S, Arenillas J F, Ayo-Martín O, Castellanos M, Freijo M M, Fuentes B, García-Pastor A, Gomis M, Gómez-Choco M, López-Cancio E, Martínez-Sánchez P, Morales A, Rodríguez-Yáñez M, Segura T, Serena J, Vivancos-Mora J, de Leciñana M A
Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, España.
Servicio de Neurología, IMIM-Hospital del Mar, Barcelona, España.
Neurologia (Engl Ed). 2022 Jan-Feb;37(1):61-72. doi: 10.1016/j.nrl.2020.07.027. Epub 2020 Nov 5.
We present an update of the Spanish Society of Neurology's recommendations for prevention of both primary and secondary stroke in patients with dyslipidaemia.
We performed a systematic review to evaluate the main aspects of the management of dyslipidaemias in primary and secondary stroke prevention and establish a series of recommendations.
In primary prevention, the patient's vascular risk should be determined in order to define target values for low-density lipoprotein cholesterol. In secondary prevention after an atherothrombotic stroke, a target value <55mg/dL is recommended; in non-atherothombotic ischaemic strokes, given the unclear relationship with dyslipidaemia, target value should be established according to the vascular risk group of each patient. In both primary and secondary prevention, statins are the drugs of first choice, and ezetimibe and/or PCSK9 inhibitors may be added in patients not achieving the target value.
我们展示了西班牙神经病学学会关于血脂异常患者原发性和继发性卒中预防建议的更新内容。
我们进行了一项系统综述，以评估原发性和继发性卒中预防中血脂异常管理的主要方面，并制定了一系列建议。
在一级预防中，应确定患者的血管风险，以定义低密度脂蛋白胆固醇的目标值。在动脉粥样硬化性血栓形成性卒中后的二级预防中，建议目标值<55mg/dL；在非动脉粥样硬化性缺血性卒中中，鉴于与血脂异常的关系不明确，应根据每位患者的血管风险组确定目标值。在一级和二级预防中，他汀类药物是首选药物，对于未达到目标值的患者可加用依泽替米贝和/或PCSK9抑制剂。
