Абстракт У больных ССЗ с атеросклерозом и дислипидемией на фоне медикаментозной терапии резидуальный риск (РР) сердечно-сосудистых осложнений остается высоким. Артериальная жесткость (АЖ) может рассматриваться в качестве интегрального маркера РР. Цель: изучить параметры региональной и локальной АЖ у больных ССЗ с атеросклерозом и дислипидемией на фоне медикаментозной терапии для определения возможных маркеров РР. Материалы и методы: обследовано 48 больных ССЗ с атеросклерозом и дислипидемией в возрасте от 35 до 76 (60±10) лет: 20 женщин и 28 мужчин, консультированных кардиологами в ФГБУ «НМИЦ кардиологии им. ак. Е.И.Чазова» Минздрава России и получавших комплексную медикаментозную терапию. Атеросклеротическое поражение брахиоцефальных артерий выявлено у 48 больных (100%), коронарных артерий у 31 (64%), гемодинамически значимое поражение артерий нижних конечностей у 9 (18%), артериальная гипертония у 37 (77%), сахарный диабет у 8 (16%), инфаркт миокарда в анамнезе у 12 (25%), у 6 острое нарушение мозгового кровообращения. Региональная АЖ изучалась методом объемной сфигмографии на аппарате VaSera 1000 по показателю CAVI, локальная АЖ общей сонной (ОСА), плечевой (ПА) и лучевой артерий (ЛА) ультразвуковым методом на аппарате Aloka Prosound α 7 с технологией эхо-трекинг по показателям : индекс жесткости β , модуль упругости Ер (кПа) , растяжимость стенки артерии (АС) (мм2/кПа). Результаты: Коэффициент вариации показателей АЖ составил от 13 до 63 % . Превышение возрастных референсных значений CAVI определялось у 25% , индекса β ОСА у 19%. Установлены статистически значимые положительные корреляции показателя CAVI с возрастом, систолическим (САД), пульсовым (ПАД) и средним АД (ср.АД); локальной жесткости ОСА с возрастом, с САД и ср.АД; локальной жесткости ЛА с уровнем САД и ДАД. Заключение: У больных ССЗ с атеросклерозом и дислипидемией на фоне медикаментозной терапии показатели региональной и локальной АЖ связаны с возрастом и уровнем АД. Превышение возрастных референсных значений показателя жесткости аорты и крупных магистральных артерий CAVI наблюдалось у каждого четвертого больного. Показатель АЖ CAVI может рассматриваться как возможный маркер РР. Для подтверждения настоящей гипотезы необходимы дальнейшие исследования.

Abstract Background and aims Based on the developed technology of preparation of ultra-small size phospholipid (PL) nanoparticles without the use of detergents/surfactants and stabilizers drug preparation, exhibiting hypolipidemic properties has been obtained. Preclinical and clinical studies have shown that phospholipid nanoparticles of 20–30 nm (PLN) have activated reverse cholesterol transport and reduced non-high-density lipoprotein cholesterol levels. The aim of the study was to compare the effect of PLN relative to placebo on the selected parameters of carbohydrate and fat metabolism in patients with combined hyperlipidemia. Methods This Phase III, randomized, double-blind, placebo-controlled, parallel-group study was conducted at 4 centers. The patients (pts) received PLN or placebo (1:1), powder for oral solution preparation (500 mg PL/dose) orally 2 times per day for 12 weeks. Biochemical parameters of carbohydrate and fat metabolism were measured. The data is presented in M (s). Statistical analysis was performed using the Mann-Whitney U-test and the Wilcoxon sign rank test. P-value <0.05 was considered statistically significant. Results A total of 100 pts with combined hyperlipidemia were randomized (age 35–70 years, males 58%). The mean age of patients was 56.4 (10.2) years, body-mass index (BMI) – 30.4 kg/m (2). Mean glucose, triglyceride (TG), fasting insulin (INS) and adiponectin (ADN) serum levels at baseline were 5.58 (0.9) mmol/l, 2.38 (0.6) mmol/l, 13.71 (6.03) mU/ml and 7.07 (2.25) μg/ml, respectively. At Week 12, PLN significantly reduced TG and insulin (p=0.03 and p=0.02, respectively). At the same time, the mean adiponectin level was increased (ns). The drug was well tolerated, and no clinically significant laboratory abnormalities were detected. Conclusions PLN therapy is well tolerated with a favorable effect on the chosen parameters of carbohydrate and fat metabolism in patients with moderate combined hyperlipidemia. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Ministry of industry and trade, Ministry of Healthcare of the Russian Federation

Background and Aims: Analysis of lipid profile in patients with overweight, obesity compared to people with normal body mass on the use of the Aterostop calculator

Background and Aims: The assessment of cardiovascular risk associated with overweight/obesity based on the use of "Aterostop" calculator (application)

Background and Aims: To assess cardiovascular risk, lipid profile indicators and provide recommendations for the treatment and prevention of CVC (cardiovascular complications) in a large sample of individuals using "Aterostop" calculator (application).

Based on the developed technology of prerparation of ultra small size phospholipid nanoparticles without the use of detergents/surfactants and stabilizers drug preparation, exhibiting hypolipidemic properties has been obtained. Preclinical studies have shown that phospholipid nanoparticles of 20–30 nm (PLN) activate reverse cholesterol transport. PLN is now at the stage of clinical trials (Phase II study completed). The aim of the study was to compare the efficacy, safety and tolerability of PLN relative to placebo in the treatment of combined hyperlipidemia. This Phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group study was conducted at 4 centers. The patients (pts) received PLN or placebo (1:1), powder for oral solution preparation (in an aqueous environment is a nanoemulsion with a particle size of 20–30 nm), 500 mg (sachet) orally 2 times a day for 12 weeks. Lipid parameters, safety and tolerability were measured. The data is presented in M (s), Me (lq; hq). Mann-Whitney U Test was to compare the significant difference of groups. P value <0.05 was considered statistically significant. A total of 100 pts with combined hyperlipidemia were randomized (age 35–70 years, males 58%).The mean age of patients was 56.4 (10.2) years. Mean total cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), TG, and apolipoprotein B 100 (apoB) levels at baseline were 5.59 (0.8) mmol/l, 4.51 (0.75) mmol/l, 2.38 (0.6) mmol/l and 114.26 (24.96) mg/dl, respectively (n=100). Mean high-density lipoprotein cholesterol (HDL-C) and Lp(a) levels at baseline were 1.0 (0.25) mmol/l and 21.1 (3.9; 20.3)mg/dl, respectively (n=100). At Week 12, PLT significantly reduced total cholesterol, non-HDL-C levels, TG and apo B compared to placebo (p=0.02, p=0.03, p=0.001 and p=0.02, respectively). At the same time, the mean HDL-C level was significantly increased (p=0.03). The drug was well tolerated and no clinically significant laboratory abnormalities were detected. This study demonstrates that therapy with PLT is well tolerated in additional beneficial effects on key lipid parameters in patients with moderate combined hyperlipidemia. Type of funding source: Public Institution(s). Main funding source(s): Ministry of industry and trade

Background and Aims: to study the features of the quantitative distribution of the spectrum of significant fatty acids (FA) in the blood of patients with coronary artery disease (regardless of sex, age)

Background and Aims: To estimate the prevalence of familial hypercholesterolemia (FH) in patients (pts) of different ages with primary hyperlipidemia from 1990 to 2017.

This article is the first publication of data of a prospective, observational study CRYSTAL the study of residual risk in patients with very high risk of cardiovascular disease and atherogenic dyslipidemia, treated with statins. The description of the purpose, objectives, design, and baseline characteristics included major patients. The data are compared with the results of Russian and International Studies of residual cardiovascular risk factors.

Application of inhibitors of HMG-CoA reductase in patients with rheumatologic diseases is currently limited by hypercholesterolemia. The presence of rheumatic diseases in a patient does not included in current algorithms for assessing cardiovascular risk. This review provides information about additional factors of cardiovascular risk in patients with various rheumatologic diseases.

Aim. To study the lipid-lowering effectiveness, as well as the effects on inflammatory markers and vascular wall function, of ezetimibe as monotherapy and in combination with initial doses of original statins (simvastatin, atorvastatin, and rosuvastatin). Material and methods. The study included 60 male and female patients with coronary heart disease and hyperlipidemia. Mean age of the participants was 61,4 years; mean baseline level of low-density lipoprotein cholesterol (LDL-CH) was 4,1 mmol/l. The participants were randomised into four groups: ezetimibe monotherapy (10 mg/d) for 24 weeks, or statin monotherapy (simvastatin, atorvastatin, or rosuvastatin; 10 mg/d) for 12 weeks with following assessment of LDL-CH levels. If target levels were not achieved on statin monotherapy, a combination of ezetimibe and statins was administered for the next 12 weeks. The effects of monotherapy and combined therapy on lipid profile, C-reactive protein, pro-inflammatory cytokines, vascular elasticity and stiffness, as well as treatment tolerability, were assessed. Results. After 3 months of the treatment, LDL-CH levels in statin monotherapy groups decreased to 2,66-2,98 mmol/l. The decrease in LDL-CH concentration in ezetimibe group (-16,4 %) was significant. After 3 months, the percentage of the patients with achieved target LDL-CH levels was 17 % for ezetimibe, 42 % for simvastatin, 31 % for atorvastatin, and 58 % for rosuvastatin. After 6 months, the patients receiving combined therapy demonstrated LDL-CH reduction by 39,5-50,6 %. From Month 3 to Month 6, the additional lipid-lowering effect of ezetimibe, as a part of combined therapy, varied from 13 % to 25,9 %. Conclusion: Adding ezetimibe (10 mg/d) to any statins reduces LDL-CH levels by extra 20-30 %. Combined therapy was required in over 50 % of the patients. Therefore, the response to statin monotherapy is not universal and in one-third of the patients could be regarded as poor. In these individuals, the “double inhibition” approach (combining statins with ezetimibe 10 mg/d) could control LDL-CH levels more effectively.

Aim. To study atorvastatin (10 and 20 mg/d) effects on lipid, C-reactive protein, and fibrinogen levels, vascular wall structure and function in patients with coronary heart disease (CHD) and primary hyperlipidemia (PHL). Material and methods. In total, 50 CHD and PHL patients were randomized into two stable-dose atorvastatin groups (10 or 20 mg/d) for 24 weeks. Atorvastatin effects on lipid levels, endothelial function, vascular wall distensibility and stiffness, as well as treatment tolerability, were examined. Results. Twenty-four-week atorvastatin therapy (10 or 20 mg/d) reduced low-density lipoprotein cholesterol (LDL-CH) level by 34,9% and 43,9%, respectively (p<0,001). At baseline, vascular wall functional parameters did not differ significantly, reaching 7,2% and 6,4% for endothelium-dependent vasodilatation (EDVD), 21,3 and 18,7 10-3/kPa for vascular wall distensibility (DC) of common carotid artery (CCA); 8,0 and 9,1 Units for vascular wall stiffness (beta-index), respectively. Three-month therapy was associated with significant increase in EDVD – by 40,2% in 10 mg/d group, and by 51,3% in 20 mg/d group. After 24 weeks of the treatment, CCA distensibility increased by 45,3% (p<0,01) and 43,6% (p<0,01) in 10 and 20 mg/d groups, respectively. Vascular wall stiffness decreased by 23,4% (p=0,008) and 25,7% (p=0,002), respectively. There was no significant association between LDL-CH decrease and EDVD, distensibility or stiffness dynamics. During 24-week follow-up, 2 adverse events (4%), linked to atorvastatin therapy, were registered. Conclusion. In CHD and PHL patients, atorvastatin (10-20 mg/d) increased EDVD by 40-51%, CCA distensibility by 43-45%, reduced vascular wall stiffness by 23-26%, and was well tolerated.

Aim. To compare effects of atorvastatin in the doses of 10 and 20 mg/d on lipid profile, C-reactive protein (hsCRP), fibrinogen levels, as well as vascular wall structure and function in patients with coronary heart disease (CHD) and primary hyperlipidemia (PHL). Material and methods. Fifty CHD and PHL patients were randomized to 10 or 20 mg/d atorvastatin doses (no titration), for 24-week period. Atorvastatin effects on lipids, treatment tolerability (symptoms ± increased hepatic enzymes), as well as on endothelial function, vessel elasticity and stiffness, were examined. Results. After 24 weeks of 10 mg/d atorvastatin treatment, levels of total cholesterol (TCH), triglycerides (TG), and low-density lipoprotein CH (LDL-CH) significantly decreased – by 25,4%, 21,7%, 34,9%, respectively. In 20 mg/d group, these figures were 27%, 15,2%, and 43,9%, respectively. No significant inter-group difference in LDL-CH levels was registered. No substantial CRP and fibrinogen level reduction was observed. During 24 weeks, 7 adverse events were registered, only 2 (4%) being related to atorvastatin therapy. Conclusion. In patients with CHD and PHL, atorvastatin (10-20 mg/d) decreased LDL-CH levels by 35-44%, and was well-tolerated. The therapy did not affect hsCRP and fibrinogen levels.