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Статины в практике терапевта
Сусеков А.В. Статины в практике терапевта. Consilium Medicum. 2024;26(10):641–648.
DOI: 10.26442/20751753.2024.10.202995
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
DOI: 10.26442/20751753.2024.10.202995
© ООО «КОНСИЛИУМ МЕДИКУМ», 2024 г.
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Susekov AV. Statins in the practice of an internal medicine specialist: A review. Consilium Medicum. 2024;26(10):641–648. DOI: 10.26442/20751753.2024.10.202995
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Аннотация
Статины как основа лечения и профилактики атеросклероза и его осложнений применяются в клинической практике более 40 лет. Результаты наблюдательных исследований свидетельствуют о том, что, несмотря на большую доказательную базу, статины в России по-прежнему назначают в низких дозах, максимум на 6 мес, что ведет к низкому проценту достижения целевых уровней холестерина липопротеинов низкой плотности и, соответственно, к высокому остаточному риску сердечно-сосудистых осложнений. В этой публикации представлен литературный обзор и аналитика основных принципов терапии статинами в первичной профилактике, интенсивной липидснижающей терапии у больных очень высокого сердечно-сосудистого риска, а также ключевые обновления безопасности снижения холестерина по различным органам и системам (печени, почкам, мышцам, нервной системе), углеводному обмену. В статье также представлен краткий обзор новых международных рекомендаций по оптимизации диагностики и лечения дислипидемий, что может быть полезно в повседневной практике терапевта.
Ключевые слова: первичная профилактика, дислипидемия, статины, эзетимиб, холестерин липопротеинов низкой плотности, рекомендации, сердечно-сосудистый риск, безопасность, сахарный диабет, миопатии, гиперферментемия, деменция, хроническая почечная недостаточность
Ключевые слова: первичная профилактика, дислипидемия, статины, эзетимиб, холестерин липопротеинов низкой плотности, рекомендации, сердечно-сосудистый риск, безопасность, сахарный диабет, миопатии, гиперферментемия, деменция, хроническая почечная недостаточность
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Statins have been used in clinical practice for more than 40 years to treat and prevent atherosclerosis and its complications. The results of observational studies indicate that, despite a large evidence base, statins in Russia are still prescribed in low doses, for a maximum of 6 months, leading to a low percentage of achieving the target levels of low-density lipoprotein cholesterol and, thus, to a high residual risk of cardiovascular complications. This paper presents a literature review and analysis of the basic principles of statin therapy in primary prevention, intensive lipid-lowering therapy in patients with very high cardiovascular risk, as well as key safety updates on cholesterol decrease for various organs and systems (liver, kidneys, muscles, nervous system), and carbohydrate metabolism. The article also provides a brief overview of new international guidelines to optimize the diagnosis and treatment of dyslipidemias, which can be useful in the day-to-day practice of an internal medicine specialist.
Keywords: primary prevention, dyslipidemia, statins, ezetimibe, low-density lipoprotein cholesterol, recommendations, cardiovascular risk, safety, diabetes mellitus, myopathies, hyperenzymemia, dementia, chronic renal failure
Полный текст
Список литературы
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Авторы
А.В. Сусеков*
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*asus99@mail.ru
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*asus99@mail.ru
________________________________________________
Andrey V. Susekov*
Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*asus99@mail.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.