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Christian Teijo Núñez L.E. M. Interna 08.11.2019

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Page 1: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

Christian Teijo NúñezL.E. M. Interna08.11.2019

Page 2: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 3: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

DIABETES: x3 (Varón). x5 (Mujer)

Indicación cálculo RCV.* Varón > 40 años

* Mujer > 50 años ó postmenopáusica.

Page 4: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

- SCORE: Riesgo a 10 años de evento cardiovascular “fatal”.

Page 5: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 6: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 7: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 8: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

LLpp((aa)) yy AAppooBB

- In general, LDL-C, non-HDL-C, and ApoBconcentrations are very highlycorrelated (ASCVD risk)

- Si TG > 400 mg/dl à Col no HDL y ApoB

Page 9: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

??

Page 10: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 11: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

RRCCVV mmooddeerraaddoo RRCCVV bbaajjoo

Page 12: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 13: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 14: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

Varón 47 años…

Page 15: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 16: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

………..

Page 17: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 18: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

RCV alto y muy alto

Page 19: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

RRCCVV mmuuyy aallttoo RRCCVV aallttoo

< 85 mg/dl

< 65 mg/dl

< 100 mg/dl

< 80 mg/dl

Page 20: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

Descenso Objetivo primario: 6.4%

Page 21: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 22: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 23: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

Varón 47 años…

Page 24: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

Modificadores de RCV

Page 25: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 26: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

- Modificadores de Riesgo / Reclasificación

• Lp(a)

- 1 Vez en la vida- Si > 180 mg/dL. RCV moderado à RCV Alto-

Page 27: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 28: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 29: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73
Page 30: Christian Teijo Núñez L.E. M. Interna 08.11 · Patients with DM without target organ damage,a with DM dutaion > 10 years or another adcitional risk Moderate CKD (eGFR 30-59 mL/min/1.73

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