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Ponte-Negretti CI, Wyss FS, Piskorz D, Santos RD, Villar R, Lorenzatti A, López-Jaramillo P, Toth PP, Amaro AJJ, Rodrigo AK, Lanas F, Urina-Triana M, Lara J, Valdés TO, Gomez-Mancebo JR, Bryce A, Cobos S L, Puente-Barragan A, Ullauri-Solórzano VE, Medina-Palomino FA, Lozada AF, Duran M, Berrospi P, Miranda D, Badimon JJ, González JJR, Libby P. Latin American Consensus on management of residual cardiometabolic risk. A consensus paper prepared by the Latin American Academy for the Study of Lipids and Cardiometabolic Risk (ALALIP) endorsed by the Inter-American Society of Cardiology (IASC), the International Atherosclerosis Society (IAS), and the Pan-American College of Endothelium (PACE). Arch Cardiol Mex 2021; 92:99-112. [PMID: 34187049 PMCID: PMC8771033 DOI: 10.24875/acm.21000005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Hypertension, hyperglycemia, dyslipidemia, overweight, obesity, and tobacco (smoking, chewing, and vaping), together with a pro-inflammatory and procoagulant state, are the main risk factors related to atherosclerotic cardiovascular disease. Objective and methods: A group of experts from the Americas, based on their clinical expertise in cardiology, cardiovascular prevention, and cardiometabolic (CM) diseases, joined together to develop these practical recommendations for the optimal evaluation and treatment of residual CM risk factors in Latin America, using a modified Delphi methodology (details in electronic TSI) to generate a comprehensive CM risk reduction guideline, and through personalized medicine and patient-centered decision, considering the cost-benefit ratio The process was well defined to avoid conflicts of interest that could bias the discussion and recommendations. Results: Residual risk reduction should consider therapeutic options adapted to specific patient needs, based on five treatment objectives: triglyceride-rich lipoproteins, inflammation, impaired glucose metabolism, high blood pressure, and prothrombotic status. Comprehensive control of all CM risk factors should be a priority to deal with this important public health problem and prevent premature deaths. The recommendations in this paper address the evidence-based treatment of CM risk and are intended for clinical application in Latin American countries.
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Affiliation(s)
| | - Fernando S Wyss
- Services and Cardiovascular Technology of Guatemala CARDIOSOLUTIONS, Guatemala, Guatemala
| | - Daniel Piskorz
- Institute of Cardiology Sanatorio Británico SRL Rosario, Argentina
| | - Raul D Santos
- Lipid Clinic Heart Institute (InCor) University of Sao Paulo Medical School Hospital, Sao Paulo, Brazil
| | | | - Alberto Lorenzatti
- Department of Cardiology, Hospital Instituto Médico DAMIC/Rusculleda Foundation for Research in Medicine, Cordoba Argentina
| | - Patricio López-Jaramillo
- Integral Center for the Prevention of Cardiometabolic Diseases (CIPCA) and Instituto Masira, UDES, Bucaramanga, Colombia
| | - Peter P. Toth
- University of Illinois College of Medicine, Peoria, Illinois, Michigan State, USA
| | | | - Alfonso K Rodrigo
- Advanced Center for Metabolic Medicine and Nutrition, Santiago de Chile, Chile
| | | | | | - Jofre Lara
- Department of Cardiology, Hospital Solca Guayaquil, Ecuador
| | | | - José R Gomez-Mancebo
- Department of Cardiology, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Alfonso Bryce
- CARDIOGOLF Research Unit, El Golf Clinic, Lima, Peru
| | - Leonardo Cobos S
- Cardiology Service, Hospital El Pino, Cardiocob Research Unit, Santiago de Chile, Chile
| | | | | | | | | | - Maritza Duran
- FISPEVEN (Foundation for Clinical Research in Public and Epidemiological Health in Venezuela), Clínica El Ávila, Caracas, Venezuela
| | | | | | - Juan J Badimon
- Atherothrombosis Research Unit, Cardiovascular Institute, The Mount Sinai School of Medicine, New York, USA
| | - J José R González
- University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Peter Libby
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Womens' Hospital, Harvard Medical School, Boston, MA, USA
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