References

arthyper

Артериальная гипертензия

"Arterial’naya Gipertenziya" ("Arterial Hypertension")

1607-419X2411-8524

Antihypertensive League

10.18705/1607-419X-2010-16-3-238-249

arthyper-1546

Research Article

КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ

CLINICAL TRIALS

Доказательная база Симвастатина (Зокора): пятнадцать лет спустя

Evidence-based data on Simvastatin: A 15-year experience

Сусеков

А. В.

Susekov

A. V.

asus99@cardio.ru

Горнякова

Н. Б.

Gornyakova

N. B.

noemail@neicon.ru

Зубарева

М. Ю.

Zubareva

M. Y.

noemail@neicon.ru

Бойцов

С. А.

Boitsov

S. A.

noemail@neicon.ru

ФГУ "Российский кардиологический научно-производственный комплекс Росмедтехнологий"РоссияFederal Agency of the High-Tekhnology Medical Care «Russian Cardiology Research Complex Rosmedtekhnologii»Russian Federation

2010

28062010

163238249

2010

Сусеков А.В., Горнякова Н.Б., Зубарева М.Ю., Бойцов С.А.

Susekov A.V., Gornyakova N.B., Zubareva M.Y., Boitsov S.A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://htn.almazovcentre.ru/jour/article/view/1546

Ингибиторы 3-гидрокси-3-метилглутарил-коэнзим-А (ГМГ-Ко-А) редуктазы (статины) широко используются при лечении больных с гиперлипидемиями и атеросклерозом уже более 30 лет. По результатам рандомизированных клинических исследований было показано, что снижение уровня холестерина липопротеидов низкой плотности на 1 % при лечении статинами приводит к достоверному снижению сердечно-сосудистого риска на 0,88 %. Симвастатин (Зокор) - полусинтетический статин 1 генерации был зарегистрирован в США для клинического применения в 1988 году. В течение последних 15 лет этот препарат интенсивно изучался в клинических исследованиях с суррогатными и клиническими конечными точками. По результатам контролируемых клинических исследований 4S, HPS, IDEAL, ACCORD, лечение Зокором в дозе 20-40 мг/сут в разных популяциях больных приводило к высокодостоверному снижению сердечно-сосудистой смертности на 24-35 %, коронарной смертности - максимально на 42 %, риска развития инсультов - на 27 % и снижению общей смертности на 13-30 %. Зокор также хорошо изучен в регрес- сионных клинических исследованиях FHRS, MAAS и СIS, по результатам которых была доказана возможность замедления прогрессирования/регрессия коронарного атеросклероза. Симвастатин (Зокор) - наиболее изученный статин с точки зрения долговременной безопасности и перено- симости. В частности, в исследовании HPS, частота повышения трансаминаз печени не превышало 1 %, а случаев миопатии - не более 0,05 %. Симвастатин также хорошо изучен в комбинированной терапии с фибратами, нико- тиновой кислотой и эзетролом. Фиксированная комбинация эзетрол 10 мг/симвастатин 20 мг (Инеджи) позволяет снижать уровень холестерина более чем на 50 %, при этом большинство пациентов достигают целевых значений липидов. По данным исследования DYSIS 2009, симвастатин является самым надежным и широко назначаемым в мире статином.

Inhibitors of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-Ko-A) reductase (statins) are widely used in treatment hyperlipideamia and atherosclerosis for more than 30 years. Results of randomized controlled trials studying statins have demonstrated that for each 1 % reduction of low-density lipoprotein (LDL) one can achieve 0,88 % reduction of cardiovascular risk. Simvastain (Zocor™) is the fi rst-generation semisynthetic statin registered by FDA in 1988. Over the past 15 years simvastatin has been widely studied in clinical trials with hard end points (4S, HPS, IDEAL, ACCORD). These trials showed that treatment with Simvastatin 20-40 mg/day may signifi cantly reduce risk of cardiovascular death by 24-35 %, coronary death - by 42 %, risk of stroke - by 27 % and total mortality - by 13-30 %. Simvastatin was also well studied in regression trials (FHRS, MAAS and CIS). Simvastatin - is the best-investigated statin in terms of long-term safety and tolerability. In particular, in HPS study the incidence of liver damage did not exceeded 0,1 %, myopathy - 0,05 %. Zocor is well studied in combination therapy with fi brates, niacin and ezetimibe. Fixed drug combination ezetemibe 10 mg/sim vastatin 20 mg may reduce LDL for more than 50 %, most of high-risk patients can achieve target LDL-C goals. According to DYSIS study (2009) simvastatin is the most reliable and widely used statin in the world.

статинысимвастатингиперлипидемияишемическая болезнь сердцадоказательная меди- цина

statinssimvastatincoronary heart diseasehyperlipideamiaevidence-based medicine

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