АГ-артериальная гипертензия, АД-артериальное давление, ДАД-диастолическое артериальное давление, ЗПА-заболевание периферических артерий, ИБС-ишемическая болезнь сердца, ИСАГизолированная систолическая артериальная гипертензия, кфСПВ-каротидно-феморальная скорость пульсовой волны, ЛЖ-левый желудочек, ЛПИ-лодыжечно-плечевой индекс, МРТ-магнитно-резонансная томография, ПАД-пульсовое артериальное давление, плСПВ-плече-лодыжечная скорость пульсовой волны, ППИ-пальце-плечевой индекс, РА-ревматоидный артрит, САД-систолическое артериальное давление, СД-сахарный диабет, СКФ-скорость клубочковой фильтрации, СПВ-скорость пульсовой волны, ССЗ-сердечно-сосудистые заболевания, ССО-сердечно-сосудистые осложнения, ССР-сердечно-сосудистый риск, УЗИ-ультразвуковое исследование, ФВ-фракция выброса, ХБП-хроническая болезнь почек, ХПН-хроническая почечная недостаточность, ХСН-хроническая сердечная недостаточность, ЦАД-центральное аортальное давление, AIx-индекс аугментации, CAVI-сердечно-лодыжечный сосудистый индекс, D-путь, пройденный волной, Δt-время запаздывания. Recently, there was plenty studies published on the arterial stiffness assessment, and importance of this was proved as an independent prediction parameter, together with standard cardiovascular risk factors. In current document, we collect and structure the available clinical and scientific data from abroad and Russian studies. The aim of current publication is the need to bring a reader the importance of demanded in clinical practice ways of arterial wall stiffness assessment, information about conditions when it is important to the assessment, and available restrictions, as the issues remaining unresolved.
АГ-артериальная гипертензия, АД-артериальное давление, ДАД-диастолическое артериальное давление, ЗПА-заболевание периферических артерий, ИБС-ишемическая болезнь сердца, ИСАГизолированная систолическая артериальная гипертензия, кфСПВ-каротидно-феморальная скорость пульсовой волны, ЛЖ-левый желудочек, ЛПИ-лодыжечно-плечевой индекс, МРТ-магнитно-резонансная томография, ПАД-пульсовое артериальное давление, плСПВ-плече-лодыжечная скорость пульсовой волны, ППИ-пальце-плечевой индекс, РА-ревматоидный артрит, САД-систолическое артериальное давление, СД-сахарный диабет, СКФ-скорость клубочковой фильтрации, СПВ-скорость пульсовой волны, ССЗ-сердечно-сосудистые заболевания, ССО-сердечно-сосудистые осложнения, ССР-сердечно-сосудистый риск, УЗИ-ультразвуковое исследование, ФВ-фракция выброса, ХБП-хроническая болезнь почек, ХПН-хроническая почечная недостаточность, ХСН-хроническая сердечная недостаточность, ЦАД-центральное аортальное давление, AIx-индекс аугментации, CAVI-сердечно-лодыжечный сосудистый индекс, D-путь, пройденный волной, Δt-время запаздывания. Recently, there was plenty studies published on the arterial stiffness assessment, and importance of this was proved as an independent prediction parameter, together with standard cardiovascular risk factors. In current document, we collect and structure the available clinical and scientific data from abroad and Russian studies. The aim of current publication is the need to bring a reader the importance of demanded in clinical practice ways of arterial wall stiffness assessment, information about conditions when it is important to the assessment, and available restrictions, as the issues remaining unresolved.
Aim. To determine the features and main problems of statin therapy, as well as assess the possibility of achieving the target level of lipid pattern in patients with high and very high cardiovascular risk (CVR) in real clinical practice.Material and methods. The design of the “PRIORITET” observational program is an open observational study. Patients with high and very high CVR were divided into 3 groups in accordance with the initial data: (1) not taking statins, (2) taking statins, but not reaching the target low-density lipoprotein cholesterol (LDL-C) level, (3) taking statins with the achievement of the target LDL-C level, which is justified in replacing the statin inside the class — adverse effects (AE), high price, etc. Within 12 weeks 3 visits of patients to hospitals were carried out: baseline visit (B0), visit 1 month after the study initiation (B1) and visit 3 months after the study initiation (B3). The choice of atorvastatin or rosuvastatin was assessed by the doctors.Results. Groups 1, 2 and 3 included 112, 170 and 16 people, respectively. At B0, 145 (48,7%) patients were prescribed atorvastatin, and 153 (51,3%) — rosuvastatin. Three people dropped out of the study to B3, 295 patients completed the program. Lipid pattern of 285 patients were analyzed: 121 (41%) people (101 with very high CVR and 20 with high CVR) achieved the target LDL-C level, the remaining 164 (59%) patients (CVR — 156 and 8, respectively) — no. The most pronounced dynamics of LDL=C level was revealed in group 1, the differences between group 1 and groups 2 and 3 are highly statistically significant (p<0,0001). There were no differences in the frequency of reaching the target LDL-C level between patients taking atorvastatin or rosuvastatin. The target level of LDL-C (p=0,003) in the treatment of rosuvastatin in patients with high CVR was reached significantly more often than in patients with very high CVR. Also 3 non-serious AEs were reported. On average, in 9% of cases, reaching the target level of LDL-С during visits B1 and B3 was wrong interpreted by the attending physicians.Conclusion. The main problems of statin therapy in real clinical practice are the wrong interpretation of reaching the target level of LDL-C, inertness of doctors in titrating of statins doses and achieving the target level of lipid pattern. It may be the cause of reduced efficiency and deterioration of lipid-lowering therapy results in patients with high and very high CVR. The results of the “PRIORITET” study demonstrated the possibility of improving the practice of statins use and its accordance with clinical guidelines.Skibitsky V. V. on behalf of the working group of the “PRIORITET” researchWorking Group of the “PRIORITET” study: Voronina V. P. (Moscow), Zelenova T. I. (Moscow), Sladkova T.A. (Moscow), Alekseeva A. I. (Tula), Barabanova T. Yu. (Tula), Zotova A. S. (Tula), Kolomeitseva T. M. (Tula), Prikhod’ko T. N. (Tula), Pazelt E. A. (Nizhny Novgorod), Khramushev N. Yu. (Nizhny Novgorod), Skibitsky A. V. (Krasnodar), Alekseeva V. V. (Saratov), Lazareva E. V. (Saratov).
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