Современные возможности снижения резидуального сердечно-сосудистого риска


DOI: https://dx.doi.org/10.18565/therapy.2024.8.105-117

О.И. Боева, Е.В. Ржевская, Е.В. Шкута, И.Р. Байбулдин, В.В. Дроздов, Е.Ю. Пучкова

1) ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, г. Москва; 2) ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ, г. Москва; 3) ФГБУ «Поликлиника № 1» Управления делами Президента РФ, г. Москва
Аннотация. Статинотерапия надежно снижает концентрацию холестерина липопротеидов низкой плотности, но не всегда эффективна в плане улучшения общего липидного профиля, что создает предпосылки к формированию резидуального (остаточного) кардиоваскулярного риска. Фибраты – агонисты активируемого пероксисомным пролифератором рецептора-α – являются мощными липид-модифицирующими препаратами. К их основным эффектам относятся снижение уровня триглицеридов и повышение уровня липопротеидов высокой плотности. Несколько рандомизированных контролируемых исследований не продемонстрировали преимущества фибратов в снижении сердечно-сосудистого риска, особенно в качестве дополнения к терапии статинами. Однако ретроспективные анализы крупных клинических исследований, метаанализы и данные исследований реальной практики свидетельствуют об их терапевтическом потенциале в популяциях пациентов с атерогенной дислипидемией и метаболическим синдромом. В обзоре представлен анализ актуальной научной литературы по проблеме коррекции смешанной дислипидемии и риска сердечно-сосудистых осложнений.

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Об авторах / Для корреспонденции


Ольга Игоревна Боева, д. м. н., профессор кафедры госпитальной терапии им. академика П.Е. Лукомского лечебного факультета ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, профессор кафедры терапии, кардиологии и функциональной диагностики с курсом нефрологии ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента РФ. Адрес: 117437, г. Москва, ул. Островитянова, д. 1, стр. 7.
E-mail: box0271@mail.ru
Елена Васильевна Ржевская, к. м. н., главный врач ФГБУ «Поликлиника № 1» Управления делами Президента РФ. Адрес: 119002, г. Москва, пер. Сивцев Вражек, д. 26/28, к. 1.
E-mail: e.rzhevskaya@vipmed.ru
Екатерина Васильевна Шкута, врач-терапевт, заведующая отделением помощи на дому ФГБУ «Поликлиника № 1» Управления делами Президента РФ. Адрес: 119002, г. Москва, пер. Сивцев Вражек, д. 26/28, к. 1.
E-mail: e.shkuta@vipmed.ru
Ильназ Радикович Байбулдин, врач общей практики отделения помощи на дому ФГБУ «Поликлиника № 1» Управления делами Президента РФ. Адрес: 119002, г. Москва, пер. Сивцев Вражек, д. 26/28, к. 1.
E-mail: i.baybuldin@vipmed.ru
Владимир Викторович Дроздов, врач общей практики отделения помощи на дому ФГБУ «Поликлиника № 1» Управления делами Президента РФ. Адрес: 119002, г. Москва, пер. Сивцев Вражек, д. 26/28, к. 1.
E-mail: v.drozdov@vipmed.ru
Екатерина Юрьевна Пучкова, врач-кардиолог кардиологического отделения ФГБУ «Поликлиника № 1» Управления делами Президента РФ. Адрес: 119002, г. Москва, пер. Сивцев Вражек, д. 26/28, к. 1.
E-mail: e.puchkova@vipmed.ru


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