The use of statines in outpatient practice in high and very highrisk patients


I.I. Shaposhnik, I.I. Reznik

1) South Ural State Medical University, Department of propaedeutics of internal diseases, Chelyabinsk; 2) Ural State Medical University, Department of therapy, Yekaterinburg
The article considers the issues related to long-term use of statins in outpatient settings. Particular attention is paid to the changed provisions for determining cardiovascular risk in the context of the European recommendations 2016 and project of new Russian recommendations under discussion. The changed rating of use of preparations for normalization of lipid profile is provided. 9 “steps” that must be completed by a doctor to optimize the evaluation and treatment of dyslipidemia are presented consistently.
Keywords: cardiovascular risk, dyslipidemia, statins
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Literature

  1. Муромцева Г.А., Концевая А.В., Константинов В.В., Артамонова Г.В., Гатагонова Т.М., Дупляков Д.В., Ефанов А.Ю., Жернакова Ю.В., Ильин В.А., Конради А.О., Либис Р.А., Минаков Э.В., Недогода С.В., Ощепкова Е.В., Романчук С.В., Ротарь О.П., Трубачева И.А., Деев А.Д., Шальнова С.А., Чазова И.Е., Шляхто Е.В., Бойцов С.А. Распространенность факторов риска неинфекционных заболеваний в российской популяции в 2012–2013 гг. Результаты исследования ЭССЕ-РФ. Кардиоваскулярная терапия и профилактика. 2014;13(6):4–11. [Muromtseva G.A., Kontsevaya A.V., Konstantinov V.V., Artamonova G.V., Gatagonova T.M., Duplyakov D.V., Efanov A.Yu., Zhernakova Yu.V., Il’in V.A., Konradi A.O., Libis R.A., Minakov E.V., Nedogoda S.V., Oshchepkova Ye.V., Romanchuk S.V., Rotar’ O.P., Trubacheva I.A., Deev A.D., Shal’nova S.A., Chazova I.Ye., Shlyakhto Ye.V., Boytsov S.A. Prevalence of risk factors of noncommunicable diseases in the Russian population in 2012–2013. The results of ESSE-RF study. Cardiovascular therapy and prevention. 2014;13(6):4–11 (in Russ.)]
  2. Catapano A., Graham I., De Backer G., Wiklund O., Chapman M.J., Drexel H., Hoes A.W., Jennings C.S., Landmesser U., Pedersen T.R., Reiner Ž., Riccardi G., Taskinen M.R., Tokgozoglu L., Verschuren W.M., Vlachopoulos C., Wood D.A., Zamorano J.L.; Authors/Task Force Members; Additional Contributor. 2016 ESC/EAS Guidelines for the Management of Dyslipidemias. Eur. Heart J. 2016:37(39):2999–3058.
  3. Rabar S., Harker M., O’Flynn N., Wierzbicki A.S.; Guideline Development Group. Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease: summary of updated NICE guidance. BMJ. 2014;349:g4356.
  4. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации (V пересмотр). Российский кардиологический журнал. 2012:4 (Прил. 1). [Diagnosis and correction of lipid metabolism disorders in prevention and treatment of atherosclerosis. Russian recommendations (V revision). Russian journal of cardiology. 2012:4 (Suppl. 1) (in Russ.)]
  5. Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS)., Catapano A.L., Reiner Z., De Backer G., Graham I., Taskinen M.R., Wiklund O., Agewall S., Alegria E., Chapman M.J., Durrington P., Erdine S., Halcox J., Hobbs R., Kjekshus J., Perrone Filardi P., Riccardi G., Storey R.F., Wood D.; ESC Committee for Practice Guidelines 2008–2010 and 2010–2012 Committees. ESC/EAS Guidelines for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Atherosclerosis. 2011;217(Suppl. 1):S1–44.
  6. Sabatine M.S., Giugliano R.P., Keech A.C., Honarpour N., Wiviott S.D., Murphy S.A., Kuder J.F., Wang H., Liu T., Wasserman S.M., Sever P.S., Pedersen T.R.; FOURIER Steering Committee and Investigators. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N. Engl. J Med. 2017;376(18):1713–22.
  7. Еганян Р.А. Роль статинов в первичной профилактике сердечно-сосудистых заболеваний. Кардиосоматика. 2012;3:64–8. [Yeganyan R.A. Role of statins in the primary prevention of cardiovascular disease. Cardiosomatic. 2012;3:64–8 (in Russ.)]
  8. Аронов Д.М., Бубнова М.Г. Плейотропные эффекты статинов на современном этапе их изучения. Кардиосоматика. 2012;3:55–64. [Aronov D.M., Bubnova M.G. Pleiotropic effects of statins at the present stage of their study. Cardiosomatic. 2012;3:55–64 (in Russ.)]
  9. Masana L. Pitavastatin in cardiometabolic disease: therapeutic profile. Cardiovasc. Diabetol. 2013;12 (Suppl. 1):S2.
  10. Дзяк Г.В., Егоров К.Ю., Колесник Э.Л. Питавастатин – новый ингибитор ГМГ-КоА-редуктазы: особенности клинической фармакологии и перспективы применения при лечении сердечно-сосудистых заболеваний. Артериальная гипертензия. 2013;6: 9–15. [Dzyak G.V., Yegorov K.Yu., Kolesnik E.L. Pitavastatin – a new inhibitor of HMG-COA reductase: specificity of clinical pharmacology and application prospects in the treatment of cardiovascular diseases. Hypertension. 2013;6: 9–15 (in Russ.)]
  11. Stone N.J., Robinson J., Lichtenstein A.H., Bairey Merz C.N., Blum C.B., et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl. 2):S1–45.
  12. Карпов Ю.А., Сергиенко И.В., Ежов М.В. Новый вектор в лечении дислипидемий: доза статина, а не целевой уровень ЛНП. Атеросклероз и дислипидемии. 2014;1:59–61. [Karpov Yu.A., Sergienko I.V., Yezhov M.V. New vector in the treatment of dyslipidemia: the dose of the statin and not the target level of LDL. Atherosclerosis and dyslipidemia. 2014;1:59–61 (in Russ.)]


About the Autors

Igor I. Shaposhnik, MD, professor, head of Department of propaedeutics of internal diseases, South Ural State Medical University. Address: 454092, Chelyabinsk, 64 Vorovskogo St. Tel.: +7-9088235120.
E-mail: shaposhnik@yandex.ru

Inna I. Reznik, MD, professor of Department of therapy, Ural State Medical University. Address: 620219, Yekaterinburg, 3 Repina St. Tel.: +79122148558. E-mail: inna-reznik2008@yandex.ru


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