aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАНateroskleroz-37Research ArticleСтатьиПРОТЕКТИВНАЯ РОЛЬ СТАТИНОВ ПРИ ВНУТРИКОРОНАРНЫХ ВМЕШАТЕЛЬСТВАХ У ПАЦИЕНТОВ С ХРОНИЧЕСКИМИ ОККЛЮЗИЯМИ ВЕНЕЧНЫХ АРТЕРИЙSTATINS PROTECTIVE ROLE IN PATIENTS WITH CHRONIC TOTAL OCCLUSIONS OF CORONARY ARTERIES IN INTRACORONARY INTERVENTIONSРагозинаА. С.RagozinaA. S.aurikasa@gmail.comПетренкоИ. В.PetrenkoI. V.noemail@neicon.ruУрванцеваИ. А.UrvantsevaI. A.noemail@neicon.ruНиколаевК. Ю.NikolaevK. Yu.noemail@neicon.ruБУ ХМАО-Югры «Окружной кардиологический диспансер «Центр диагностики и сердечно-сосудистой хирургии»РоссияState-Financed Organization Khanty-Mansi Autonomous Region - Ugra “District Cardiodispensary “Centre of Diagnosis and Cardiovascular Surgery”Russian FederationФГБНУ НИИ терапии и профилактической медициныРоссияInstitute of Internal and Preventive MedicineRussian Federation2017270920191313540Copyright © Рагозина А.С., Петренко И.В., Урванцева И.А., Николаев К.Ю., 20192019Рагозина А.С., Петренко И.В., Урванцева И.А., Николаев К.Ю.Ragozina A.S., Petrenko I.V., Urvantseva I.A., Nikolaev K.Y.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/37

Обзор посвящен современному состоянию проблемы использования статинов в интервенционной кардиологии. Показано, что применение статинов у пациентов как со стабильными проявлениями ишемической болезни сердца, так и с острым коронарным синдромом оказывает протективное действие, что выражается в уменьшении периоперационной ишемии миокарда, улучшении систолической функции левого желудочка, снижении числа неблагоприятных сердечных событий. Известно, что протективная роль статинов связана не только с холестеринснижающим эффектом, но также с большим количеством плейотропных эффектов. Большое внимание уделено сложной и проблемной группе пациентов с хроническими окклюзиями коронарных артерий (ХОКА). Наличие ХОКА связано с неблагоприятным прогнозом и увеличением смертности в отдаленном периоде. Существенной проблемой при проведении чрескожных коронарных вмешательств (ЧКВ) у пациентов с ХОКА является частое развитие периоперационной ишемии или инфаркта миокарда, что связано с увеличением смертности в течение 30 дней после ЧКВ, а также в отдаленном периоде. В настоящее время наиболее доказано проективное действие аторвастатина. На основании анализа современной литературы сделан вывод, что эффективность статинов в профилактике осложнений ЧКВ у пациентов с ХОКА в настоящее время не вызывает сомнений.

The article is devoted to the current state of the problem of statin use in interventional cardiology. It is shown that the use of statins in patients with stable manifestations of coronary heart disease, and in patients with acute coronary syndrome has a protective effect, which is reflected in the reduction of perioperative myocardial ischemia, improvement of left ventricular systolic function, reducing the number of adverse cardiac events. It is known that the protective role of statins is associated not only with the cholesterol-lowering effect, but also with a large number of pleiotropic effects. A lot of attention is paid to the complex and problematic group of patients with chronic total occlusions of coronary arteries (CTO). The presence of CTO is associated with poor prognosis and increased mortality in long-term period. A significant problem during percutaneous coronary intervention (PCI) in patients with the CTO is a frequent development of perioperative ischemia or myocardial infarction, which is associated with an increased mortality rates within 30 days after PCI, as well as in the long-term period. Currently, mostly proved protective effect of atorvastatin. Based on the analysis of contemporary literature is concluded that statin efficacy in the prevention of complications of PCI in patients with CTO is currently not in doubt.

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The authors declare that there are no conflicts of interest present.