Cardiopatía coronaria isquémica y tuberculosis: una sindemia inadvertida.Revisión de la literatura y propuesta de manejo

Mauricio Andrés Murillo Moreno; Laura Valentina López Gutiérrez; Eric Edward Vinck; Gustavo Roncancio Villamil; Catalina Gallego Muñoz; Clara Inés Saldarriaga Giraldo

doi:10.47487/apcyccv.v5i2.375

Autores/as

Mauricio Andrés Murillo Moreno Departamento de Medicina Interna, Universidad CES, Medellín, Colombia. https://orcid.org/0000-0001-7673-4965
Laura Valentina López Gutiérrez Departamento de Cardiología, Clínica Cardio VID, Medellín, Colombia. https://orcid.org/0000-0001-9660-202X
Eric Edward Vinck Departamento de Cirugía Cardiovascular, Clínica Cardio VID, Medellín, Colombia. https://orcid.org/0000-0002-9728-3910
Gustavo Roncancio Villamil Departamento de Enfermedades Infecciosas, Clínica Cardio VID, Medellín, Colombia. https://orcid.org/0000-0002-2677-6398
Catalina Gallego Muñoz Departamento de Cardiología, Clínica Cardio VID, Medellín, Colombia.
Clara Inés Saldarriaga Giraldo Departamento de Cardiología, Clínica Cardio VID, Medellín, Colombia. https://orcid.org/0000-0002-5945-1127

DOI:

https://doi.org/10.47487/apcyccv.v5i2.375

Palabras clave:

Tuberculosis, Insuficiencia Cardiaca, Enfermedad Coronaria, Infarto del Miocardio

Resumen

La tuberculosis es una enfermedad que viene en aumento y que afecta cerca de un tercio de la población mundial. En consonancia con el aumento de la tuberculosis, la enfermedad cardiovascular ha tenido un comportamiento similar, de este grupo, la cardiopatía coronaria isquémica se ha convertido en la principal causa de muerte en todo el mundo. Se podría extraer, en base a la literatura, una relación entre la tuberculosis y la cardiopatía coronaria isquémica a través de que comparten múltiples factores de riesgo en común y desde un posible sustrato fisiopatológico que las vincula. La forma conjunta de presentación de estas dos entidades reportada hasta el momento es variada: se ha encontrado como debut de un síndrome coronario agudo en pacientes con tuberculosis activa, el desarrollo progresivo de aterosclerosis coronaria en pacientes con tuberculosis latente, entre otras. Dado este posible vínculo y el aumento progresivo de sus tasas de incidencia podemos afirmar que estamos ante una sindemia inadvertida, siendo su manejo conjunto un desafío por las grandes interacciones farmacológicas. El propósito de esta revisión es esclarecer este posible vínculo, plantear un enfoque para el diagnóstico así como suministrar un algoritmo de tratamiento de todo el espectro de la enfermedad coronaria que coexiste con la tuberculosis de acuerdo con la literatura actual disponible.

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