cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2012-3-82-86cardiovascular-1827Research ArticleМНЕНИЕ ПО ПРОБЛЕМЕOPINION ON A PROBLEMСубклинический атеросклероз как фактор риска сердечно-сосудистых осложненийSubclinical atherosclerosis as a risk factor of cardiovascular eventsБойцовС. А.BoytsovS. A.v_kukharch@mail.ruКухарчукВ. В.KukharchukV. V.v_kukharch@mail.ruКарповЮ. А.KarpovYu. A.v_kukharch@mail.ruСергиенкоИ. В.SergienkoI. V.v_kukharch@mail.ruДрапкинаО. М.DrapkinaO. M.v_kukharch@mail.ruСеменоваА. Е.SemenovaA. E.v_kukharch@mail.ruУразалинаС. Ж.UrazalinaS. Zh.v_kukharch@mail.ruРоссийский кардиологический научно-производственный комплекс Минздравсоцразвития России, МоскваRussian Cardiology Scientific and Clinical Complex, Moscow2012200620121138286Copyright © Бойцов С.А., Кухарчук В.В., Карпов Ю.А., Сергиенко И.В., Драпкина О.М., Семенова А.Е., Уразалина С.Ж., 20122012Бойцов С.А., Кухарчук В.В., Карпов Ю.А., Сергиенко И.В., Драпкина О.М., Семенова А.Е., Уразалина С.Ж.Boytsov S.A., Kukharchuk V.V., Karpov Y.A., Sergienko I.V., Drapkina O.M., Semenova A.E., Urazalina S.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1827

Субклинический атеросклероз является начальной скрытой формой хронического, прогрессирующего, воспалительного заболевания артерий. Дестабилизация асимптомных, гемодинамически не значимых атеросклеротических бляшек (АБ) может стать причиной инфаркта миокарда, острого нарушения мозгового кровообращения или даже внезапной смерти. Поскольку в реальной клинической практике оценка стабильности АБ затруднена, необходимо учитывать сам факт наличия субклинического атеросклероза в стратификации риска больных. Частота выявления АБ при дуплексном сканировании сонных артерий у лиц с низким и умеренным риском по шкале SCORE составила 59% (358 человек из 600) при анализе популяции больных, наблюдавшихся в поликлиниках Западного административного округа г. Москвы. До настоящего времени не разработаны четкие критерии стратификации сердечно-сосудистого риска по факту наличия субклинического атеросклероза, хотя его значимость в прогнозе не вызывает сомнений. Требуются большие крупномасштабные исследования по оценке прогноза у больных с субклиническим атеросклерозом для уточнения возможности использования этого параметра как независимого фактора риска и разработки рекомендаций по изменению тактики ведения больных.

Subclinical atherosclerosis is an initial, latent stage of chronic progressing arterial inflammation. Destabilisation of asymptomatic, hemodynamically non-significant atherosclerotic plaques (AP) could lead to myocardial infarction, stroke, or sudden death. Since the assessment of AP stability is problematic in real-world clinical settings, the risk stratification should, at least, account for the presence of subclinical atherosclerosis. In 600 ambulatory patients from the Moscow City Western Administrative Okrug who had low and moderate SCORE-assessed cardiovascular risk levels, the prevalence of AP, based on the duplex carotid ultrasound results, was 59% (n=358). Presently, no standard guidelines exist on cardiovascular risk stratification which would include the assessment of subclinical atherosclerosis, despite the importance of the latter as a prognostic factor. Large clinical studies on prognosis in patients with subclinical atherosclerosis will clarify the role of this parameter as an independent cardiovascular risk factor and facilitate the development of respective clinical recommendations.

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