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Vol. 6. Núm. D.
Utilidad terapéutica de los ácidos grasos omega-3
Páginas 20D-30D (Junio 2006)
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Vol. 6. Núm. D.
Utilidad terapéutica de los ácidos grasos omega-3
Páginas 20D-30D (Junio 2006)
Utilidad terapéutica de los ácidos grasos omega-3
Acceso a texto completo
Estatinas y ácidos grasos omega-3. Disminución de la mortalidad cardiovascular dependiente e independiente de la reducción de la colesterolemia
Statins and Omega-3 Fatty Acids. Reduction in Cardiovascular Mortality With or Without a Reduction in Cholesterolemia
Visitas
...
José Martínez-González, Lina Badimon??
Autor para correspondencia
lbadimon@csic-iccc.santpau.es

Correspondencia: Prof. L. Badimon. Centro de Investigación Cardiovascular. Hospital de la Santa Creu i Sant Pau. Sant Antoni Maria Claret, 167. 08025 Barcelona. España.
Centro de Investigación Cardiovascular. CSIC/ICCC. Hospital de la Santa Creu i Sant Pau. Barcelona. España
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El consumo de alimentos ricos en ácidos grasos omega-3 o la ingesta de complementos que contienen estos compuestos reducen la morbimortalidad cardiovascular. El beneficio clínico de estos compuestos es independiente de la reducción de colesterol pues, aunque disminuyen significativamente las concentraciones de triglicéridos de forma dependiente de la dosis, no modifican prácticamente los concentraciones de colesterol unido a lipoproteínas de baja densidad. Además, los resultados del estudio GISSI indican que la reducción de la mortalidad cardiovascular puede deberse principalmente a sus efectos antiarrítmicos. La necesidad de controlar las concentraciones de triglicéridos y de colesterol en pacientes con hiperlipidemia combinada plantea la cuestión de si la administración de estos compuestos junto con las estatinas, que mejora el perfil lipídico en estos pacientes, también puede incrementar la reducción de la mortalidad cardiovascular. En este artículo se revisan los mecanismos a través de los cuales ejercen su efecto clínico los ácidos grasos omega-3 y se analiza en qué medida su acción «farmacológica» complementa la actividad hipolipidemiante de las estatinas y puede ser aditiva sobre los efectos pleiotrópicos de estos fármacos. De hecho, los resultados parciales del estudio JELIS (Japan EPA Lipid Intervention Study) señalan que el tratamiento combinado con ambos podría aumentar la protección cardiovascular y reducir la mortalidad.

Palabras clave:
Ácidos grasos omega-3
Estatinas
Hipercolesterolemia
Efectos pleiotrópicos
Estudios clínicos
Abreviaturas:
AGPI
ALA
CI
COX
DART
DHA
EPA
FMD
GISSI
HDL
IAM
ICAM-I
IECA
JELIS
LDL
LOX
LTB5
NCEP
NO
PAI-1
RR
4S
TFPI
TNT
TXA3
VCAM-I
VLDL

Omega-3 polyunsaturated fatty acids reduce cardiovascular morbidity and mortality. The clinical benefit of these compounds is independent of the reduction in cholesterol level because they decrease the triglyceride level significantly in a dose-dependent manner while having practically no effect on the low-density lipoprotein cholesterol level. In addition, the results of the GISSI study indicate that the reduction in cardiovascular mortality associated with these compounds may be principally due to their antiarrhythmic properties. The need to control both triglyceride and cholesterol levels in patients suffering mixed hyperlipidemia raises the question of whether combined administration of these compounds with statins (a combination known to improve the lipid profile in these patients) further reduces cardiovascular mortality. In this article, we review the mechanisms responsible for the clinical effects of omega-3 fatty acids and discuss the extent to which their «pharmacological» action complements the lipid-lowering effects of statins and could supplement the pleiotropic effects of these drugs. In fact, early results of the Japan EPA Lipid Intervention Study (JELIS) suggest that combined treatment with omega-3 fatty acids and statins could increase cardiovascular protection and reduce mortality.

Key words:
Omega-3 fatty acids
Statins
Hypercholesterolemia
Pleiotropic effects
Clinical trials
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