Перспективы применения эзетимиба в кардиологической практике

В патогенезе атеросклероза важная роль отводится инфильтрации сосудистой стенки липопротеидами, в частности, холестерином липопротеидов низкой плотности (ХС ЛНП). Повышенный уровень ХС ЛНП увеличивает риск развития ишемической болезни сердца (ИБС). В экспериментальных и клинических исследованиях выявлена прямая связь между снижением уровня ХС ЛНП и уменьшением частоты сердечно-сосудистых заболеваний. Препаратами выбора для снижения уровня ХС ЛНП являются статины. Однако монотерапия статинами не всегда приводит к достижению целевого уровня ХС ЛНП (особенности фармакогенетики, непереносимость препарата, побочные явления, возникающие при приеме терапевтически эффективных доз статина). В таких случаях целесообразно использование комбинации статинов, обычно в невысокой дозе, с другими гиполипидемическими препаратами. В последнее время опубликованы данные по хорошей эффективности комбинирования статинов с ингибитором абсорбции ХС в кишечнике — эзетимибом. Эта эффективность обусловлена воздействием на оба механизма, определяющих уровень ХС в крови, — абсорбция в кишечнике и синтез в печени. Одновременное ингибирование этих двух процессов ведет к выраженному снижению уровня ХС ЛНП.

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