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Медицинский Совет

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Новые клинические и фармакологические аспекты применения аторвастатина с целью первичной и вторичной профилактики осложнений сердечно-сосудистых заболеваний

https://doi.org/10.21518/2079-701X-2018-16-110-117

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Аннотация

В статье обсуждаются новые данные, полученные в ходе выполнения нескольких крупных обсервационных исследований, в которых оценивали качество профилактики развития сердечно-сосудистых заболеваний, обусловленных атеросклерозом, в современной популяции. Обсуждается проблема недостаточно частого использования гиполипидемических препаратов в современной клинической практике. Приводятся новые данные о преимуществах применения статинов, и в частности аторвастатина, с целью не только вторичной, но и первичной профилактики, а также о сохранении эффективности и безопасности терапии статинами в течение длительного периода. Рассматриваются возможные преимущества применения аторвастатина, включая возможность более быстрого достижения клинического эффекта, которое было отмечено в ходе выполнения РКИ, что может играть роль при выборе определенного статина в определенных клинических ситуациях. Обсуждаются недавно опубликованные результаты анализа данных об участниках исследования ASCOT-LLA (AngloScandinavian Cardiac Outcomes Trial  – Lipid Lowering Arm), которые были получены при длительном наблюдении. Приводятся новые данные о, возможно, чрезмерно консервативном подходе к выбору целевых уровней холестерина липопротеинов низкой плотности в крови, которые были получены в ходе выполнения крупных обсервационных исследований. Рассматривается современная концепция «изначальной профилактики» сердечно-сосудистых заболеваний, обусловленных атеросклерозом. Приводятся недавно полученные данные об особенностях применения аторвастатина в клинической практике, которые могут стать дополнительным основанием для увеличения частоты его применения в клинической практике с целью как вторичной, так и первичной профилактики.

Об авторах

С. Р. Гиляревский
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России
Россия
д.м.н., профессор кафедры клинической фармакологии и терапии


М. В. Голшмид
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России
Россия
к.м.н., доцент кафедры клинической фармакологии и терапии


И. М. Кузьмина
НИИ скорой помощи им.Н.В. Склифосовского
Россия
к.м.н., ведущий научный сотрудник отделения неотложной кардиологии


И. И. Синицина
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России
Россия
д.м.н., профессор кафедры клинической фармакологии и терапии


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