<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0186-4866</journal-id>
<journal-title><![CDATA[Medicina interna de México]]></journal-title>
<abbrev-journal-title><![CDATA[Med. interna Méx.]]></abbrev-journal-title>
<issn>0186-4866</issn>
<publisher>
<publisher-name><![CDATA[Edición y Farmacia S.A. de C.V.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0186-48662018000100008</article-id>
<article-id pub-id-type="doi">10.24245/mim.v34i1.1451</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[El legado científico y el papel actual de la atorvastatina en el manejo del riesgo de enfermedad cardiovascular aterosclerótica]]></article-title>
<article-title xml:lang="en"><![CDATA[The scientific legacy and the current role of atorvastatin in the management of risk of atherosclerotic cardiovascular disease]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alcocer Díaz-Barreiro]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Solache-Ortiz]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aldrete-Velasco]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano de Salud Cardiovascular  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General de San Juan del Río  ]]></institution>
<addr-line><![CDATA[San Juan del Río Qro]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Paracelsus, SA de CV  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2018</year>
</pub-date>
<volume>34</volume>
<numero>1</numero>
<fpage>57</fpage>
<lpage>71</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0186-48662018000100008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0186-48662018000100008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0186-48662018000100008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Durante mucho tiempo, los esfuerzos para disminuir el riesgo cardiovascular en los adultos se centraron en el intento de reducir tanto como fuese posible las concentraciones plasmáticas de colesterol 6, LDL (c-LDL). Hasta muy recientemente se concluyó que en los estudios clínicos de medicamentos con acción en los lípidos circulantes no existía evidencia directa que permitiera determinar cuál es la mejor meta de c-LDL para la disminución del riesgo cardiovascular y tampoco se concedió importancia suficiente a los eventos adversos de las diferentes combinaciones farmacológicas recomendadas para el logro de las concentraciones de c-LDL más bajas posibles. El análisis exhaustivo realizado para la actualización del Programa para el Control del Colesterol en el Adulto de Estados Unidos (NCEP-ATP-III), que comprendió una gran cantidad de estudios controlados con distribución al azar, permitió en 2013 la postulación de un nuevo paradigma de tratamiento que abandona el concepto de metas determinadas de c-LDL y que insiste en la importancia de las modificaciones favorables en el estilo de vida, además de que recomienda la administración preferencial de estatinas, en tipos y dosis fijas, debido a que un importante volumen de evidencia ha demostrado que estos agentes atenúan la progresión de la aterosclerosis coronaria y promueven la regresión de ésta, con lo que disminuyen significativamente la morbilidad y mortalidad cardiovasculares en la prevención primaria y en la secundaria. En este nuevo paradigma terapéutico fue posible también la identificación de los grupos de pacientes que pueden beneficiarse con la administración de estatinas. En consensos y guías más recientes, algunas asociaciones sostienen la necesidad de lograr ciertas metas de cLDL de acuerdo con el riesgo, pero mantienen a las estatinas como el pilar del tratamiento, solas o en combinación con ezetimiba o con antagonistas de la convertasa de proproteínas subtilisina/kexina de tipo 9 (PCSK9: proprotein convertase subtilisin/kexin type 9). En este artículo se revisa la evidencia clínica relativa a la administración de atorvastatina, que en gran medida permitió el desarrollo del nuevo paradigma de manejo del riesgo cardiovascular.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract For a long time, efforts to reduce cardiovascular risk in adults focused on the attempt to reduce plasmatic LDL cholesterol (LDLc) levels as much as possible. Until very recently, it was concluded that in clinical studies of drugs with action on circulating lipids, there was no direct evidence to determine the best LDLc target for cardiovascular risk reduction, and that adverse events, or the almost absent demonstration of impact on hard outcomes of the different pharmacological combinations recommended for the achievement of the lowest possible LDLc concentrations, were not considered. The comprehensive analysis for the update of NCEP-ATP-III (National Cholesterol Education Program, Adult Treatment Panel III), which included a large number of controlled and randomized trials, allowed in 2013 the postulation of a new treatment paradigm, which leaves the concept of specific goals of LDLc and postulates the importance of favorable lifestyle modifications and which commends the pre-ferential use of statins, fixed doses and type, because a large volume of evidence has shown that these agents attenuate the progression of coronary atherosclerosis and promote the regression of this, which significantly decrease cardiovascular morbidity and mortality in both primary and secondary prevention. In this new therapeutic paradigm, it was also possible to identify the groups of patients that can benefit from the use of statins. In more recent consensuses and guidelines, some associations support the need to achieve risk-adjusted LDLc, but keep statins as the mainstay of treatment, alone or in combination with ezetimibe or proprotein convertase subtilisin/kexin type 9 (PCKS-9) antagonists. This article reviews the clinical evidence regarding the use of atorvastatin, which allowed the development of the new cardiovascular risk management paradigm.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Atorvastatina]]></kwd>
<kwd lng="es"><![CDATA[colesterol LDL (c-LDL)]]></kwd>
<kwd lng="es"><![CDATA[dislipidemias]]></kwd>
<kwd lng="es"><![CDATA[inhibidores de hidroximetilglutaril-CoA reductasas]]></kwd>
<kwd lng="es"><![CDATA[hipercolesterolemia]]></kwd>
<kwd lng="en"><![CDATA[Atorvastatin]]></kwd>
<kwd lng="en"><![CDATA[Cholesterol, LDL (LDLc)]]></kwd>
<kwd lng="en"><![CDATA[Dyslipidemias]]></kwd>
<kwd lng="en"><![CDATA[Hydroxymethylglutaryl-CoA reductase inhibitors]]></kwd>
<kwd lng="en"><![CDATA[Hypercholesterolemia]]></kwd>
</kwd-group>
</article-meta>
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