arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2021-27-1-16-28arthyper-2015Research ArticleСтатьиArticlesСтатины у пациента с ишемическим инсультом: как рано начинать терапию?Statins in patients with acute ischemic stroke: when we should start therapy?https://orcid.org/0000-0002-6484-286XЯнишевскийС. Н.YanishevskiyS. N.

Янишевский Станислав Николаевич — доктор медицинских наук, доцент, заведующий научно-исследовательской лабораторией неврологии и нейрореабилитации ФГБУ НМИЦ им. В. А. Алмазова Минздрава России.

Санкт-Петербург

Stanislav N. Yanishevskiy - MD, PhD, DSc, Asssociate Professor, Head, Research Laboratory for Neurology and Neurorehabilitation.

St Petersburg

yanishevkiy_sn@almazovcentre.ruhttps://orcid.org/0000-0003-1955-1032СкибаЯ. Б.SkibaI. B.

Скиба Ярослав Богданович — кандидат медицинских наук, врач-невролог Научно-исследовательского института онкологии, гематологии и трансплантологии имени Р. М. Горбачевой ФГБОУ ВО ПСПбГМУ им. акад. И. П. Павлова Минздрава России.

Ул. Л. Толстого, д. 6–8, СанктПетербург, 197022

Iaroslav B. Skiba - MD, PhD, Neurologist, Research Institute of Oncology. Hematology and Transplantology n. a. R. M. Gorbacheva.

6–8 L. Tolstoy street, St Petersburg, 197022

yaver-99@mail.ruhttps://orcid.org/0000-0001-8699-2482ПолушинА. Ю.PolushinA. Y.

Полушин Алексей Юрьевич — кандидат медицинских наук, врач-невролог Научно-исследовательского института онкологии, гематологии и трансплантологии имени Р. М. Горбачевой, ассистент кафедры неврологии ФГБОУ ВО ПСПбГМУ им. акад. И. П. Павлова Минздрава России.

Санкт-Петербург

Alexey Y. Polushin - MD, PhD, Neurologist, Research Institute of Oncology. Hematology and Transplantology n. a. R. M. Gorbacheva.

St Petersburg

Федеральное государственное бюджетное учреждение Национальный медицинский исследовательский центр имени В.А. Алмазова Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова Министерства здравоохранения Российской ФедерацииРоссияPavlov UniversityRussian Federation2021060420212711628Copyright © Янишевский С.Н., Скиба Я.Б., Полушин А.Ю., 20212021Янишевский С.Н., Скиба Я.Б., Полушин А.Ю.Yanishevskiy S.N., Skiba I.B., Polushin A.Y.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/2015

Несмотря на важность гиполипидемической терапии для вторичной профилактики острого нарушения мозгового кровообращения по ишемическому типу, сроки начала терапии статинами у пациентов с ишемическим инсультом или рестарта ранее принимавшейся терапии строго не определены. В то же время продолжают накапливаться данные о наличии иных (помимо гиполипидемического механизма клинической эффективности) «плейотропных» механизмов действия статинов, в том числе при ишемии, определяя необходимость внедрения их в реальную клиническую практику. В настоящем обзоре обсуждаются данные об эффективности тактики раннего назначения статинов при ишемическом инсульте у различных групп пациентов и определяется непосредственно время назначения статинов после появления острой неврологической симптоматики, формируется оригинальная позиция авторов по данному вопросу.

Lipid-lowering therapy is known to be an important part of ischemic stroke secondary prevention, however, the exact timing of its initiation or re-starting in the patients with ischemic stroke is not yet defined strictly. Accumulating evidence of pleiotropic (i. e. non-lipid-lowering) effects of statins in various conditions, including ischemia, urges their implementation in the clinical practice. In this review, we discuss the evidence on the effectiveness of early statin introduction in different populations of patients with ischemic stroke. We also attempt to define our original position on the optimal time after the acute onset of neurological symptoms to introduce lipid-lowering therapy.

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