Estrategias preventivas del Síndrome Coronario Agudo: Revisión de alcance
DOI:
https://doi.org/10.70881/hnj/v4/n3/163Palabras clave:
Síndrome Coronario Agudo, prevención cardiovascular, factores de riesgo, rehabilitación cardiaca, enfermería comunitariaResumen
El Síndrome Coronario Agudo (SCA) representa una de las principales causas de morbimortalidad cardiovascular mundial. Su prevención mediante estrategias primarias, secundarias y terciarias permiten reducir la aparición de eventos, recurrencias y complicaciones asociadas. El objetivo de este estudio es analizar las estrategias de prevención del SCA descritas en la literatura científica reciente. Se realizó una revisión de alcance con enfoque cualitativo basada en la metodología de Joanna Briggs Institute (JBI) y PRISMA-ScR. La búsqueda se efectuó en PubMed, Scopus, SciELO y BVS, incluyendo estudios publicados entre el 2020 y 2026 en español, ingles y portugués. Se incluyeron 26 estudios, predominando la prevención secundaria (73%), seguida de la terciaria (15%) y la primaria (12%). Las principales estrategias identificadas fueron el control de factores de riesgo cardiovascular, tratamiento hipolipemiante intensivo, terapia antiagregante personalizada, rehabilitación cardiaca, intervenciones digitales, optimización farmacológica y prevención de complicaciones posteriores a la revascularización. De este estudio se puede concluir que la prevención del SCA requiere un abordaje integral basado en intervenciones farmacológicas, educativas y conductuales. La enfermería familiar y comunitaria desempeña un papel esencial mediante la educación sanitaria, seguimiento continuo, promoción del autocuidado y aplicación de estrategias basadas en evidencia para disminuir el riesgo cardiovascular
Descargas
Referencias
Abidi, S., John, D., Dwivedi, S., Sharma, V., Kumar, A., & Talegaonkar, S. (2026). Rentabilidad de Clopidogrel en pacientes con síndrome coronario agudo sometidos a intervención coronaria percutánea en la India. Value in Health Regional Issues. https://doi.org/10.1016/j.vhri.2026.101635 DOI: https://doi.org/10.1016/j.vhri.2026.101635
Ahmadimoghaddam, D., Talebi, S. S., Rahmani, A., Zamanirafe, M., Parvaneh, E., Ranjbar, A., . . . Mehrpooya, M. (2023). Prevention of Contrast Induced-Acute Kidney Injury Using Coenzyme Q10 in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. European Journal of Clinical Pharmacology, 79. https://doi.org/10.1007/s00228-023-03554-3 DOI: https://doi.org/10.1007/s00228-023-03546-9
American Heart Association. (2024). Calculadora en línea PREVENT™. Obtenido de https://professional.heart.org/en/guidelines-and-statements/prevent-calculator
American Heart Association. (2025). Guía ACC/AHA de 2019 sobre la prevención primaria de enfermedades cardiovasculares: Informe del Grupo de Trabajo del Colegio Americano de Cardiología/Asociación Americana del Corazón sobre Guías de Práctica Clínica. American Heart Association, 140(11). Obtenido de https://www.ahajournals.org/doi/10.1161/CIR.0000000000001309
Asefa, E. T., Gemmechu, T. D., A/Fogi, M. M., & Tukeni, K. N. (2025). Increase in Cardiovascular Disease Mortality in Low- and Middle-Income Countries: A Time for Action. Ethiopian Journal of Health Sciences. https://doi.org/10.4314/ejhs.v35i1.1 DOI: https://doi.org/10.4314/ejhs.v35i1.1
Ashburn, N. P., Snavely, A. C., Ehrig, M. R., Shapiro, M. D., Herrington, D. M., Reboussin, D. M., . . . Mahler, S. A. (2025). Initiating Preventive Hyperlipidemia Care in the Emergency Department: The Emergency Medicine Cardiovascular Risk Assessment for Lipid Disorders Trial. Critical Pathways in Cardiology, 24(3). https://doi.org/10.1097/HPC.0000000000000390 DOI: https://doi.org/10.1097/HPC.0000000000000390
Balady, G. J., Ades, P. A., Bittner, V. A., Franklin, B. A., Arena, R., Beatty, A. L., & al., e. (2024). Core Components of Cardiac Rehabilitation Programs: 2024 Update. Circulation. https://doi.org/10.1161/CIR.0000000000001271 DOI: https://doi.org/10.1161/CIR.0000000000001271
Bansal, A. B., & Cassagnol, M. (2023). HMG-CoA Reductase Inhibitors. Obtenido de https://www.ncbi.nlm.nih.gov/books/NBK542212/
Briguori, C., Quintavalle, C., Mariano, E., D'Agostino, A., Scarpelli, M., Focaccio, A., . . . Condorelli, G. (2024). Kidney Injury After Minimal Radiographic Contrast Administration in Patients With Acute Coronary Syndromes. Journal of the American College of Cardiology (JACC), 83(11). Obtenido de https://www.jacc.org/doi/10.1016/j.jacc.2024.01.016 DOI: https://doi.org/10.1016/j.jacc.2024.01.016
Brucato, F., Tognola, C., Moreo, A., Bellomare, M., Prencipe, G. P., Lettino, M., . . . Maloberti, A. (2025). Elegibilidad para Icosapent etil en pacientes sometidos a rehabilitación cardíaca: un estudio de cohorte del mundo real. International Journal of Cardiology. https://doi.org/10.1016/j.ijcard.2025.134046 DOI: https://doi.org/10.1016/j.ijcard.2025.134046
Burnier, M., & Brunner, H. R. (2000). Angiotensin II receptor antagonists. The Lancet. https://doi.org/10.1016/S0140-6736(99)10365-9 DOI: https://doi.org/10.1016/S0140-6736(99)10365-9
Byrne, R. A., Rosselló, X., Coughlan, J. J., Barbato, E., Berry, C., Chieffo, A., . . . al., e. (2023). 2023 ESC Guidelines for the management of acute coronary syndromes. European Heart Journal, 44(38). https://doi.org/10.1093/eurheartj/ehad191
Carlberg, B., Samuelsson, O., & Lindholm, L. H. (2024). McKeever, Rita G.; Patel, Preeti; Hamilton, Richard J. Obtenido de https://www.ncbi.nlm.nih.gov/books/NBK482473/
Cenko, E., Yoon, J., Bergami, M., Vasiljevic, Z., Mendieta, G., Zdravkovic, M., . . . Bugiardini, R. (2026). Standard modifiable cardiovascular risk factors and acute coronary syndrome free survival. Atherosclerosis, 417. https://doi.org/10.1016/j.atherosclerosis.2025.120616 DOI: https://doi.org/10.1016/j.atherosclerosis.2025.120616
Chan, C. W., Lopez, V., & Chung, J. W. (2010). A qualitative study of the perceptions of coronary heart disease among Hong Kong Chinese people. Journal of Clinical Nursing, 20(7). https://doi.org/10.1111/j.1365-2702.2010.03526.x DOI: https://doi.org/10.1111/j.1365-2702.2010.03526.x
Coellar, J. D., Keshvani, N., Jain, A. K., Usman, M. S., Segar, M. W., Miller, J. W., . . . Pandey, A. (2026). Una estrategia de polipíldora para la reducción de lípidos y la terapia antiplaquetaria después del síndrome coronario agudo: un ensayo controlado aleatorio piloto. American Journal of Preventive Cardiology, 27. https://doi.org/10.1016/j.ajpc.2026.101499 DOI: https://doi.org/10.1016/j.ajpc.2026.101499
Committee, W., Cardiology, A. C., & Association, A. H. (2026). 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia. Journal of the American College of Cardiology (JACC). https://doi.org/10.1016/j.jacc.2025.11.016 DOI: https://doi.org/10.1016/j.jacc.2025.11.016
De Sio, V., Gragnano, F., Capolongo, A., Guarnaccia, N., Maddaluna, P., Acerbo, V., . . . Anton. (2025). Eligibility for and Practical Implications of Semaglutide in Overweight and Obese Patients With Acute Coronary Syndrome. International Journal of Cardiology. https://doi.org/10.1016/j.ijcard.2025.133028 DOI: https://doi.org/10.1016/j.ijcard.2025.133028
Derington, C. G., Berchie, R. O., Greene, T., Jacobs, J. A., Moran, A. E., Xu, Y., . . . Bress, A. P. (20 de Octubre de 2025). Using PREVENT Equations to Compare Intensive vs Standard Systolic Blood Pressure Control for Primary Prevention in SPRINT. Journal of the American College of Cardiology, 86(17). https://dx.doi.org/10.1016/j.jacc.2025.07.037 DOI: https://doi.org/10.1016/j.jacc.2025.07.037
Galli, M., Laudani, C., Occhipinti, G., Spagnolo, M., Gragnano, F., D'Amario, D., . . . Capodanno, D. (2024). P2Y12 inhibitor monotherapy after short DAPT in acute coronary syndrome: a systematic review and meta-analysis. European Heart Journal - Cardiovascular Pharmacotherapy, 10(7). https://doi.org/10.1093/ehjcvp/pvae057 DOI: https://doi.org/10.1093/ehjcvp/pvae057
Garea, S. C., & Díaz, M. J. (2025). Nursing interventions for cardiovascular disease prevention: A narrative review of evidence-based strategies. BMC Nursing, 24(7). https://doi.org/10.1186/s12912-025-03885-1 DOI: https://doi.org/10.1186/s12912-025-03885-1
Holm, J., Vanky, F., & Svedjeholm, R. (2024). Association of Glutamate Infusion With Risk of Acute Kidney Injury Following Coronary Artery Bypass Surgery: A Pooled Analysis of 2 Randomized Clinical Trials. JAMA Network Open, 7(1). Obtenido de https://pmc.ncbi.nlm.nih.gov/articles/PMC10804267/ DOI: https://doi.org/10.1001/jamanetworkopen.2023.51743
Iqbal, S., Ali, N. F., Ladak, L. A., Shivji, R., Zulfiqar, M., & Barolia, R. (2023). The Scope of Practice for Primary Cardiovascular Disease Prevention Expanded to Advanced Practice Providers: What Does the Data Show? Current Cardiology Reports, 25(7). https://doi.org/10.1007/s11886-023-01899-2 DOI: https://doi.org/10.1007/s11886-023-01899-2
Ishikawa, T., Natsuaki, M., Watanabe, H., Morimoto, T., Yamamoto, K., Obayashi, Y., . . . Kimura, T. (2025). Aspirin-Free Strategy for PCI in Patients With High Bleeding Risk With or Without Acute Coronary Syndrome: A Subgroup Analysis From the STOPDAPT-3 Trial. Circulation: Cardiovascular Interventions, 18(7). https://doi.org/10.1161/CIRCINTERVENTIONS.124.015197 DOI: https://doi.org/10.1161/CIRCINTERVENTIONS.124.015197
Johner, N., Branca, M., Carballo, D., Baggio, S., Nanchen, D., Tessitore, E., . . . Windecker, S. (2025). Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort. European Journal of Preventive Cardiology, 32(8). https://doi.org/10.1093/eurjpc/zwae346 DOI: https://doi.org/10.1093/eurjpc/zwae346
Khader, A. O., van Trier, T., van der Brug, S., Liem, A.-h., Groenemeijer, B. E., Schut, A., . . . Alings, M. A. (2024). Effects of a stepwise LDL-C reduction strategy in patients with post-acute coronary syndrome. Netherlands Heart Journal, 32(5). https://doi.org/10.1007/s12471-023-01851-7 DOI: https://doi.org/10.1007/s12471-023-01851-7
Khattab, T., & Aljeesh, Y. (2025). Risk factors of acute coronary syndrome among patients admitted to cardiac care units at governmental hospitals in the Gaza Strip: Case-control study. International Journal of Cardiology: Cardiovascular Risk and Prevention, 26. https://doi.org/10.1016/j.ijcrp.2025.200466 DOI: https://doi.org/10.1016/j.ijcrp.2025.200466
Lee, S., Kim, J. B., Shin, S. E., Ahn, J., Jeong, H.-G., Jung, K. H., . . . Kim, E. J. (2025). Tailored Messages for Secondary Prevention After Percutaneous Coronary Intervention: Randomized Controlled Trial. Journal of Medical Internet Research, 27. https://doi.org/10.2196/81524 DOI: https://doi.org/10.2196/81524
Lindholm, L. H., Carlberg, B., & Samuelsson, O. (2005). Should β blockers remain first choice in the treatment of primary hypertension? A meta-analysis. The Lancet, 366. https://doi.org/10.1016/S0140-6736(05)67573-3 DOI: https://doi.org/10.1016/S0140-6736(05)67573-3
Obayashi, Y., Natsuaki, M., Watanabe, H., Morimoto, T., Yamamoto, K., Nishikawa, R., & Kimura, T. (2025). Aspirin vs Clopidogrel 1 Month After Acute Coronary Syndrome With High-Bleeding Risk or ST-Segment Elevation. JACC: Cardiovascular Interventions, 18(17). Obtenido de https://www.jacc.org/doi/10.1016/j.jcin.2025.03.029 DOI: https://doi.org/10.1016/j.jcin.2025.03.029
Obayashi, Y., Natsuaki, M., Watanabe, H., Morimoto, T., Yamamoto, K., Nishikawa, R., . . . Takenaka, H. (2024). Aspirin-free strategy for percutaneous coronary intervention in acute coronary syndrome based on the subtypes of acute coronary syndrome and high bleeding risk: the STOPDAPT-3 trial. European Heart Journal - Cardiovascular Pharmacotherapy, 10(5). https://doi.org/10.1093/ehjcvp/pvae009
Obayashi, Y., Natsuaki, M., Watanabe, H., Morimoto, T., Yamamoto, K., Nishikawa, R., . . . Takenaka, H. (2024). Aspirin-free strategy for percutaneous coronary intervention in acute coronary syndrome based on the subtypes of acute coronary syndrome and high bleeding risk: the STOPDAPT-3 trial. European Heart Journal - Cardiovascular Pharmacotherapy, 10(5). https://doi.org/10.1093/ehjcvp/pvae009 DOI: https://doi.org/10.1093/ehjcvp/pvae046
Okada, K., Kikuchi, S., Maejima, N., Kawaura, N., Kodama, S., Nakayama, N., . . . Hanajima, Y. (2025). Effect of Intensified Multifactorial Treatments on Coronary Atherosclerosis in Patients With Coronary Artery Disease and Type 2 Diabetes Mellitus: Rationale and Design of the Randomized IMPACT-DM Trial. Circulation Journal, 89. https://doi.org/10.1253/circj.CJ-24-0625 DOI: https://doi.org/10.1253/circrep.CR-25-0021
Organización Mundial de la Salud. (2025). Cardiovascular diseases (CVDs). (O. M. (OMS), Editor) Recuperado el 09 de 05 de 2026, de https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
Organización Panameriacana de la Salud. (2019). Calculadora de Riesgo Cardiovascular. Recuperado el 27 de 07 de 2026, de https://www.paho.org/es/hearts-americas/calculadora-riesgo-cardiovascular
Pedro-Botet, J. (2025). Icosapent Ethyl: From the REDUCE-IT Trial to Clinical Practice. Clínica e Investigación en Arteriosclerosis (English Edition), 37. https://doi.org/10.1016/j.arteri.2025.500820 DOI: https://doi.org/10.1016/j.artere.2025.500820
Peng, X., Olsen, M. H., Pareek, M., Bai, J., Liu, Y., Song, Q., & Cai, J. (2025). Impact of Antihypertensive Drug Classes on Cardiovascular Outcomes: Insights From the STEP Study. BMC Medicine, 23. https://doi.org/10.1186/s12916-025-04158-z DOI: https://doi.org/10.1186/s12916-025-04158-z
Persson, P. B., Tepel, M., van der Molen, A. J., Mehran, R., Barrett, B. J., Nijssen, E. C., & al., e. (2023). Prevention of contrast-associated acute kidney injury in an era of increasingly complex interventional procedures. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1180861 DOI: https://doi.org/10.3389/fmed.2023.1180861
Polat, F., Tüner, H., Çakmak, Ç. B., & Özbek, E. (2025). Impact of Cardiac Rehabilitation on Adherence to Secondary Prevention Measures Across STEMI, NSTEMI, and Unstable Angina Pectoris Subgroups: A Randomized Controlled Trial in High-Risk Patients. Acta Cardiologica, 80. https://doi.org/10.1080/00015385.2025.2576433 DOI: https://doi.org/10.1080/00015385.2025.2576433
Prasad, K. (2021). Current Status of Primary, Secondary, and Tertiary Prevention of Coronary Artery Disease. International Journal of Angiology, 30(3). Obtenido de https://pmc.ncbi.nlm.nih.gov/articles/PMC8580611/ DOI: https://doi.org/10.1055/s-0041-1731273
Qiu, X., Wang, Y., Ke, J., Wang, M., Zeng, H., Zhu, H., & Gu, J. (2025). Preventive Effect of Shenfu Injection on Arrhythmia After Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction: A Prospective Randomized Controlled Trial. Cardiovascular Therapeutics, 2025. https://doi.org/10.1155/cdr/4097327 DOI: https://doi.org/10.1155/cdr/4097327
Reijnders, E., Bossuyt, P. M., Jukema, J. W., Ruhaak, L. R., Romijn, F. P., Szarek, M., . . . Schwartz, G. G. (2025). Multiplex Apolipoprotein Panel Improves Cardiovascular Event Prediction and Cardiovascular Outcome by Identifying Patients Who Benefit From Targeted PCSK9 Inhibitor Therapy. Arteriosclerosis, Thrombosis, and Vascular Biology, 45(11). https://doi.org/10.1161/ATVBAHA.124.322336 DOI: https://doi.org/10.1161/ATVBAHA.124.322336
Rosselló, X., Barrabés, J. A., Piepoli, M., Domínguez-Rodríguez, A., Sánchez, P. L., Anguita, M., . . . Torres, A. (2026). Effect of beta blockers in acute and chronic coronary syndromes without reduced ejection fraction: A landmark analysis from the REBOOT trial. European Heart Journal – Cardiovascular Pharmacotherapy. https://doi.org/10.1093/ehjcvp/pvag002 DOI: https://doi.org/10.1093/ehjcvp/pvag002
Schwalm, J. D., McKee, M., Huffman, M. D., & Yusuf, S. (2016). Resource Effective Strategies to Prevent and Treat Cardiovascular Disease. Circulation, 133(8). https://doi.org/10.1161/CIRCULATIONAHA.115.008721 DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.008721
Sociedad Europea de Cardiología . (2023). Guías ESC 2023 para el manejo de los síndromes coronarios agudos: Elaboradas por el grupo de trabajo sobre el manejo de los síndromes coronarios agudos de la Sociedad Europea de Cardiología (ESC). (O. U. Press, Ed.) Sociedad Europea de Cardiología (ESC), 44(38). https://doi.org/10.1093/eurheartj/ehad191 DOI: https://doi.org/10.1093/eurheartj/ehad191
Vilariño, J. O., Esper, R., & Badimón, J. J. (2024). Fisiopatología de los síndromes coronarios agudos. Tres paradigmas para un nuevo dogma. Revista Española de Cardiología , 4(6). Obtenido de https://www.revespcardiol.org/es-fisiopatologia-de-los-sindromes-coronari-articulo-13071736-pdf-file
Xie, G., Patel, A., Du, X., Sun, Y., Li, X., Wu, T., . . . Wu, Y. (2025). Impact of In-Hospital Quality of Care Improvement Initiative on Secondary Prevention of Acute Coronary Syndrome in Six Months After Patient Discharge: A Large Stepped Wedge- and Cluster-Randomized Controlled Trial. Circulation: Cardiovascular Quality and, 18(5). https://doi.org/10.1161/CIRCOUTCOMES.124.011441 DOI: https://doi.org/10.1161/CIRCOUTCOMES.124.011441
Xu, F.-F., Xie, X.-F., Hu, H.-Y., Tong, R.-S., & Peng, C. (2024). Shenfu injection: A review of pharmacological effects on cardiovascular diseases. Frontiers in Pharmacology, 15. https://doi.org/10.3389/fphar.2024.1279584 DOI: https://doi.org/10.3389/fphar.2024.1279584
Yang, S., Kang, J., Park, K. W., Hur, S.-H., Lee, N. H., Hwang, D., . . . colaboradores, y. (2023). Comparison of Antiplatelet Monotherapies After Percutaneous Coronary Intervention According to Clinical, Ischemic, and Bleeding Risks. JACC (Journal of the American College of Cardiology), 82(16). Obtenido de https://www.jacc.org/doi/10.1016/j.jacc.2023.07.031 DOI: https://doi.org/10.1016/j.jacc.2023.07.031
Zhang, S., Li, J., Qiu, M., Li, Y., Wang, X., Wang, Z., . . . Han, Y. (2025). Comparación de la monoterapia con clopidogrel frente a la DAPT prolongada basada en la puntuación de riesgo GRACE en pacientes con síndromes coronarios agudos con alto riesgo isquémico y de sangrado: un análisis de subgrupos del ensayo clínico aleatorizad. European Journal of Pharmacology. https://doi.org/10.1016/j.ejphar.2025.178151 DOI: https://doi.org/10.1016/j.ejphar.2025.178151
Ziogos, E., Harb, T., Valenta, I., Vavuranakis, M. A., Foran, P. L., Williams, M. S., . . . Leucker, T. M. (2025). Impact of In-Hospital PCSK9 Inhibition on Myocardial Inflammation After Myocardial Infarction: A Randomized Clinical Trial. JACC: Basic to Translational Science, 10(6). https://doi.org/10.1016/j.jacbts.2025.03.010 DOI: https://doi.org/10.1016/j.jacbts.2025.03.010
Publicado
Número
Sección
Licencia
Derechos de autor 2026 Jonathan Gabriel Chuga Guaman, Lissete Carolina Zambrano Sanguinetti, Juan Alberto Chávez Gaibor (Autor/a)
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Cómo citar
:
