33321 - Epidemiologadelaembolia2001 Aurora K. Pajeau, M.D.,...

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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 1 Epidemiología de la embolia-2001 Aurora K. Pajeau , M.D., MPH Director de Embolia LSUHSC-Shreveport
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 2 Embolia -2001 3ª principal causa de muerte en los Estados Unidos Americanos Una causa principal de discapacidad en adultos Se estiman 750,000 incidentes anuales de embolia >4 millones de sobrevivientes a la embolia
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 3 Factores de riesgo modificables  bien documentados para embolia HTN (Edad50-80 ) 20-55% 40-20 4.0-1.4 38% Tabaquismo 25% 12-18 1.8 50% /c 1año DM 20% 14-58 1.8-6 /c BP Asxto Carotida Stn 2-8% 2-7 2.0 50% TC H 55a 25% 25 1.8/ 240-279 20-30% M 65a 40% 2.6/>280 /c estatinas A Fib 0.5-8.8% 1.5-23 5 2.6-4.5 68% A/C 21%ASA Adaptado de Goldstein et al: Stroke 2001;32:280-299 Factor Prevalencia PAR% RR %Risk /c Tx
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 4 Hiperlipidemia ~36% (60x10 6 ) adultos en EUA Niveles promedio de TC aumentan en hombres entre 55-64 luego disminuyen. 25% de hombres americanos y 28% de mujeres tienen niveles de TC >240mg/dl (6.21mm/l)
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 5 Endotelio normal
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 6 Placa fibrosa
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 8 Estímulo iniciador de ateroesclerosis Hipertensión Fuerzas mecánicas, respuesta completa al stress Oxidación LDL  Adhesión, permeabilidad, deposición Homocisteina  [O] LDL, toxina vascular Cigarrillos Toxico, productos de la oxidación glicativa Hiperglicemia  Retención arterial de triglicéridos Infección Traumatismo de la pared vascular
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 9 Nuevos factores de riesgo Hiperhomocisteinemia Infección e inflamación Factores genéticos adicionales Desórdenes hemostáticos y de la coagulación Inactividad por ocio y obesidad Abuso de comida rápida Tabaquismo pasivo
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Thursday , June 14, 2001 Congress of Epidemiology 2001Toronto, Canada 10 Hiperhomocisteinemia HC es altamente reactiva a aminoácidos tóxicos para el endotelio vascular Efecto pro-aterogénico y pro-trombótico sobre los vasos sanguíneos
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33321 - Epidemiologadelaembolia2001 Aurora K. Pajeau, M.D.,...

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