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Medicina & Laboratorio

2008, Número 09-10

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Medicina & Laboratorio 2008; 14 (09-10)


Proteína C reactiva ultrasensible (PCR-us) como marcador de riesgo de enfermedad cardiovascular

Domínguez-Amorocho O, Patiño-Cuervo D

Idioma: Español
Referencias bibliográficas: 58
Paginas: 457-478
Archivo PDF: 789.01 Kb.


RESUMEN

La importancia de los factores de riesgo clásicos ha sido demostrada para el desarrollo de la enfermedad cardiovascular. Aun así, se han identificado nuevos factores de riesgo, llamados factores de riesgo emergentes, que optimizan el manejo y la detección del riesgo cardiovascular y en consecuencia benefician la población con más programas eficientes de prevención. Para mejorar la predicción del riesgo cardiovascular, la comunidad científica ha centrado su interés en la determinación de la proteína C reactiva ultrasensible (PCR-us), como un marcador de inflamación, puesto que diferentes estudios epidemiológicos prospectivos han demostrado su utilidad en la predicción de la incidencia de algunas enfermedades cardiovasculares, tales como infarto agudo de miocardio, accidente cerebrovascular y enfermedad vascular periférica. Adicionalmente, varias investigaciones de los últimos años han mostrado la participación de diferentes células y moléculas de la respuesta inmune, como mediadores de la lesión vascular relacionada con la ateroesclerosis. La proteína C reactiva es una proteína de fase aguda que ha sido clásicamente considerada como un marcador de inflamación. Bajo condiciones normales, su síntesis hepática es menor a 1 mg/L, la cual se ve incrementada en una persona que desarrolla un proceso inflamatorio o infeccioso. Esta elevación puede ser hasta de 100 veces el valor normal durante las primeras 24 a 48 horas y se mantiene así por varios días. Se ha demostrado que la PCR-us brinda información en cada uno de los niveles de riesgo cardiovascular de acuerdo a la escala de Framingham; niveles de PCR-us menores a 1 mg/L, entre 1 y 3 mg/L, y mayores a 3 mg/L, corresponden al riesgo cardiovascular bajo, medio y alto, respectivamente. El valor predictor de la PCR-us se incrementa cuando es evaluado en asociación con el perfil lipídico y se realiza una correlación apropiada.


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