Низкий уровень триглицеридов независимо связан с низким риском коронарных событий. Данные испытания PROVE IT-TIMI 22

§Ј §Я§Ц§Х§С§У§Я§Ц§Ю §Ю§Ц§д§С-§С§Я§С§Э§Ъ§Щ§Ц §б§в§а§г§б§Ц§Ь§д§Ъ§У§Я§н§з §Ъ§г§б§н§д§С§Я§Ъ§Ы §е§г§д§С§Я§а§У§Э§Ц§Я§а §Я§Ц§Щ§С§У§Ъ§г§Ъ§Ю§а§Ц §б§в§а§Ф§Я§а§г§д§Ъ§й§Ц§г§Ь§а§Ц §Щ§Я§С§й§Ц§Я§Ъ§Ц §е§в§а§У§Я§с §д§в§Ъ§Ф§Э§Ъ§и§Ц§в§Ъ§Х§а§У (§ґ§Ф) §Х§Э§с §в§Ъ§г§Ь§С §г§Ц§в§Х§Ц§й§Я§а-§г§а§г§е§Х§Ъ§г§д§а§Ы §Щ§С§Т§а§Э§Ц§У§С§Ц§Ю§а§г§д§Ъ*. §°§г§д§С§Ц§д§г§с §Я§Ц§У§н§с§г§Я§Ц§Я§Я§н§Ю §У§Э§Ъ§с§Я§Ъ§Ц §Я§Ъ§Щ§Ь§Ъ§з §ґ§Ф §Я§С §в§Ъ§г§Ь §Ь§а§в§а§Я§С§в§Я§н§з §г§а§Т§н§д§Ъ§Ы §е §б§С§и§Ъ§Ц§Я§д§а§У, §е§Ш§Ц §Ъ§Ю§Ц§р§л§Ъ§з §а§й§Ц§Я§о §Я§Ъ§Щ§Ь§Ъ§Ц §Щ§Я§С§й§Ц§Я§Ъ§с §з§а§Э§Ц§г§д§Ц§в§Ъ§Я§С §Э§Ъ§б§а§б§в§а§д§Ц§Ъ§Х§а§У §Я§Ъ§Щ§Ь§а§Ы §б§Э§а§д§Я§а§г§д§Ъ (§·§г §­§±§Ї§±). §Ґ§Э§с §а§д§У§Ц§д§С §Я§С §п§д§а§д §У§а§б§в§а§г §Ъ§г§г§Э§Ц§Х§а§У§С§д§Ц§Э§Ъ, §б§в§а§У§а§Х§Ъ§У§к§Ъ§Ц §Ъ§г§б§н§д§С§Я§Ъ§Ц PROVE IT-TIMI 22** (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction), §У§н§б§а§Э§Я§Ъ§Э§Ъ §У§д§а§в§Ъ§й§Я§н§Ы §С§Я§С§Э§Ъ§Щ §б§а§Э§е§й§Ц§Я§Я§н§з §Х§С§Я§Я§н§з. 

§®§Ц§д§а§Х§н §Ъ §з§а§Х §Ъ§г§г§Э§Ц§Х§а§У§С§Я§Ъ§с.

§Ј §Ъ§г§б§н§д§С§Я§Ъ§Ц §Т§н§Э§а §У§Ь§Э§р§й§Ц§Я§а 4162 §б§С§и§Ъ§Ц§Я§д§С, §Ф§а§г§б§Ъ§д§С§Э§Ъ§Щ§Ъ§в§а§У§С§Я§Я§н§з §б§а §б§а§У§а§Х§е §а§г§д§в§а§Ф§а §Ь§а§в§а§Я§С§в§Я§а§Ф§а §г§Ъ§Я§Х§в§а§Ю§С (§°§¬§і) §Ъ §Ъ§Ю§Ц§р§л§Ъ§з §е§в§а§У§Ц§Я§о §а§Т§л§Ц§Ф§а §з§а§Э§Ц§г§д§Ц§в§Ъ§Я§С (§°§·§г)<240 §Ю§Ф/§Х§Э (6,2 §Ю§Ю§а§Э§о/§Э) §Ъ§Э§Ъ <200 §Ю§Ф/§Х§Э (5,2 §Ю§Ю§а§Э§о/§Э), §Ц§г§Э§Ъ §б§а§Э§е§й§С§Э§Ъ §Э§Ъ§б§Ъ§Х§г§Я§Ъ§Ш§С§р§л§е§р §д§Ц§в§С§б§Ъ§р. §µ§й§С§г§д§Я§Ъ§Ь§Ъ §Т§н§Э§Ъ §в§С§Я§Х§а§Ю§Ъ§Щ§Ъ§в§а§У§С§Я§н §Я§С §б§а§Э§е§й§Ц§Я§Ъ§Ц §Ъ§Я§д§Ц§Я§г§Ъ§У§Я§а§Ы §Э§Ъ§б§Ъ§Х§г§Я§Ъ§Ш§С§р§л§Ц§Ы §д§Ц§в§С§б§Ъ§Ъ (§С§д§а§в§У§С§г§д§С§д§Ъ§Я 80 §Ю§Ф §У §г§е§д§Ь§Ъ) §Ъ§Э§Ъ §г§д§С§Я§Х§С§в§д§Я§а§Ц §Э§Ц§й§Ц§Я§Ъ§Ц (§б§в§С§У§С§г§д§С§д§Ъ§Я 40 §Ю§Ф §У §г§е§д§Ь§Ъ) §У §д§Ц§й§Ц§Я§Ъ§Ц 2 §Э§Ц§д. §°§·§г, §ґ§Ф, §з§а§Э§Ц§г§д§Ц§в§Ъ§Я §Э§Ъ§б§а§б§в§а§д§Ц§Ъ§Х§а§У §У§н§г§а§Ь§а§Ы §б§Э§а§д§Я§а§г§д§Ъ (§·§г §­§±§Ј§±) §Т§н§Э§Ъ §Ъ§Щ§Ю§Ц§в§Ц§Я§н §б§в§Ъ §У§Ь§Э§р§й§Ц§Я§Ъ§Ъ, §й§Ц§в§Ц§Щ 1, 4, 8, 16, 24 §Ю§Ц§г§с§и§С §Ъ §У§а §У§в§Ц§Ю§с §Щ§С§Ь§Э§р§й§Ъ§д§Ц§Э§о§Я§а§Ф§а §У§Ъ§Щ§Ъ§д§С. §·§г §­§±§Ї§± §в§С§г§г§й§Ъ§д§н§У§С§Э§г§с §б§а §ж§а§в§Ю§е§Э§Ц §°§·§г ЁC (§ґ§Ф/5 + §·§г §­§±§Ј§±) §Ъ§Э§Ъ §Ъ§Щ§Ю§Ц§в§с§Э§г§с §Я§Ц§б§а§г§в§Ц§Х§г§д§У§Ц§Я§Я§а, §Ц§г§Э§Ъ §е§в§а§У§Ц§Я§о §ґ§Ф §б§в§Ц§У§н§к§С§Э 400 §Ю§Ф/§Х§Э (4,5 §Ю§Ю§а§Э§о/§Э).

§Ў§У§д§а§в§н §б§а§г§д§С§У§Ъ§Э§Ъ §и§Ц§Э§о§р §б§в§а§г§Э§Ц§Х§Ъ§д§о §г§У§с§Щ§о §е§в§а§У§Я§Ц§Ы §ґ§Ф §Ъ §·§г §­§±§Ї§±, §Х§а§г§д§Ъ§Ф§Я§е§д§н§з §й§Ц§в§Ц§Щ 30 §г§е§д§а§Ь §д§Ц§в§С§б§Ъ§Ъ, §г §й§С§г§д§а§д§а§Ы §Ь§а§Ю§Т§Ъ§Я§Ъ§в§а§У§С§Я§Я§а§Ы §б§Ц§в§У§Ъ§й§Я§а§Ы §Ь§а§Я§Ц§й§Я§а§Ы §д§а§й§Ь§Ъ (§г§Ю§Ц§в§д§о, §Ъ§Я§ж§С§в§Ь§д §Ю§Ъ§а§Ь§С§в§Х§С §Ъ§Э§Ъ §Ф§а§г§б§Ъ§д§С§Э§Ъ§Щ§С§и§Ъ§с §б§а §б§а§У§а§Х§е §°§¬§і).       

§І§Ц§Щ§е§Э§о§д§С§д§н.

§Ў§Я§С§Э§Ъ§Щ§е §б§а§Х§У§Ц§в§Ф§Я§е§д§н §Х§С§Я§Я§н§Ц 3718 §Т§а§Э§о§Я§н§з (§г§в§Ц§Х§Я§Ъ§Ы §У§а§Щ§в§С§г§д ЁC 58 §Э§Ц§д, §Ю§е§Ш§й§Ъ§Я§н ЁC 79%, §Ь§е§в§Ъ§Э§о§л§Ъ§Ь§Ъ ЁC 36%,

§Э§Ъ§и§С §г §С§в§д§Ц§в§Ъ§С§Э§о§Я§а§Ы §Ф§Ъ§б§Ц§в§д§Ц§Я§Щ§Ъ§Ц§Ы ЁC 49% §Ъ §г §а§Ш§Ъ§в§Ц§Я§Ъ§Ц§Ю ЁC 39%).
§№§Ц§в§Ц§Щ 30 §г§е§д§а§Ь §д§Ц§в§С§б§Ъ§Ъ 34,5% §б§С§и§Ъ§Ц§Я§д§а§У §Ъ§Ю§Ц§Э§Ъ §е§в§а§У§Ц§Я§о §ґ§Ф ЎЭ 150 §Ю§Ф/§Х§Э (1,7 §Ю§Ю§а§Э§о/§Э). §Ј §д§Ц§й§Ц§Я§Ъ§Ц §Х§С§Э§о§Я§Ц§Ы§к§Ц§Ф§а §Я§С§Т§Э§р§Х§Ц§Я§Ъ§с (§а§д 30 §г§е§д§а§Ь §Х§а 2 §Э§Ц§д) §й§С§г§д§а§д§С §б§Ц§в§У§Ъ§й§Я§а§Ы §Ь§а§Я§Ц§й§Я§а§Ы §д§а§й§Ь§Ъ §а§Ь§С§Щ§С§Э§С§г§о §Щ§Я§С§й§Ъ§д§Ц§Э§о§Я§а §Ю§Ц§Я§о§к§Ц §е §Т§а§Э§о§Я§н§з §г §·§г §­§±§Ї§± < 70 §Ю§Ф/§Х§Э (1,8 §Ю§Ю§а§Э§о/§Э), §й§Ц§Ю §б§в§Ъ §·§г §­§±§Ї§± ЎЭ 70 §Ю§Ф/§Х§Э: 13,0% §б§в§а§д§Ъ§У 16,2% §г§а§а§д§У§Ц§д§г§д§У§Ц§Я§Я§а (§а§д§Я§а§к§Ц§Я§Ъ§Ц §в§Ъ§г§Ь§С [§°§І] ЁC 0,81; 95% §Х§а§У§Ц§в§Ъ§д§Ц§Э§о§Я§н§Ы §Ъ§Я§д§Ц§в§У§С§Э [§Ґ§Є] ЁC 0,68ЁC0,96; §в=0,015). §Ў§Я§С§Э§а§Ф§Ъ§й§Я§а §Ю§Ц§Я§о§к§Ц §г§а§Т§н§д§Ъ§Ы §а§д§Ю§Ц§й§Ц§Я§а §е §б§С§и§Ъ§Ц§Я§д§а§У §г §е§в§а§У§Я§Ц§Ю §ґ§Ф < 150 §Ю§Ф/§Х§Э, §й§Ц§Ю §б§в§Ъ §ґ§Ф ЎЭ 150 §Ю§Ф/§Х§Э: 13,2% §б§в§а§д§Ъ§У 17,6% (§У §а§Х§Я§а§ж§С§Ь§д§а§в§Я§а§Ю §С§Я§С§Э§Ъ§Щ§Ц §°§І ЁC 0,73; 95% §Ґ§Є ЁC 0,62ЁC0,87; §в<0,001). §±§а§г§Э§Ц §Ь§а§в§в§Ц§Ь§и§Ъ§Ъ §Я§С §У§а§Щ§в§С§г§д, §б§а§Э, §У§н§г§а§Ь§Ъ§Ы §е§в§а§У§Ц§Я§о §·§г §­§±§Ї§±, §Я§Ъ§Щ§Ь§Ъ§Ы §е§в§а§У§Ц§Я§о §·§г §­§±§Ј§±, §Ь§е§в§Ц§Я§Ъ§Ц, §Ф§Ъ§б§Ц§в§д§Ц§Я§Щ§Ъ§р, §Х§Ъ§С§Т§Ц§д, §б§в§Ц§Х§к§Ц§г§д§У§е§р§л§Ц§Ц §Э§Ц§й§Ц§Я§Ъ§Ц §г§д§С§д§Ъ§Я§а§Ю, §б§Ц§в§Ц§Я§Ц§г§Ц§Я§Я§н§Ы §°§¬§і §Ъ §п§ж§ж§Ц§Ь§д §д§Ц§в§С§б§Ъ§Ъ §в§Ъ§г§Ь §б§Ц§в§У§Ъ§й§Я§а§Ы §Ь§а§Я§Ц§й§Я§а§Ы §д§а§й§Ь§Ъ §б§в§Ъ §ґ§Ф < 150 §Ю§Ф/§Х§Э §а§г§д§С§У§С§Э§г§с §Х§а§г§д§а§У§Ц§в§Я§а §Я§Ъ§Ш§Ц (§°§І ЁC 0,80; 95% §Ґ§Є ЁC 0,66ЁC0,97; §в=0,025). §Ј §г§в§С§У§Я§Ц§Я§Ъ§Ъ §г §б§С§и§Ъ§Ц§Я§д§С§Ю§Ъ, §Ъ§Ю§Ц§У§к§Ъ§Ю§Ъ §·§г §­§±§Ї§± ЎЭ 70 §Ю§Ф/§Х§Э §Ъ §ґ§Ф ЎЭ 150 §Ю§Ф/§Х§Э, §Я§С§Ъ§Ю§Ц§Я§о§к§Ъ§Ы §в§Ъ§г§Ь §Я§С§Т§Э§р§Х§С§Э§г§с §е §Т§а§Э§о§Я§н§з §г §·§г §­§±§Ї§± < 70 §Ю§Ф/§Х§Э §Ъ §ґ§Ф < 150 §Ю§Ф/§Х§Э (§°§І ЁC 0,72; §в=0,017). §і§Я§Ъ§Ш§Ц§Я§Ъ§Ц §е§в§а§У§Я§с §ґ§Ф §Я§С §Ь§С§Ш§Х§н§Ц 10 §Ю§Ф/§Х§Э §а§г§д§С§У§С§Э§а§г§о §Щ§Я§С§й§Ъ§Ю§а §г§У§с§Щ§С§Я§Я§н§Ю §г §в§Ц§Х§е§Ь§и§Ъ§Ц§Ы §в§Ъ§г§Ь§С §Ь§а§в§а§Я§С§в§Я§н§з §г§а§Т§н§д§Ъ§Ы §Я§С 1,6% §б§а§г§Э§Ц §Ю§Я§а§Ф§а§ж§С§Ь§д§а§в§Я§а§Ы §б§а§б§в§С§У§Ь§Ъ, §У§Ь§Э§р§й§С§р§л§Ц§Ы §·§г §­§±§Ї§± (§в<0,001), §Ъ §Я§С 1,4% §б§а§г§Э§Ц §б§а§б§в§С§У§Ь§Ъ, §У§Ь§Э§р§й§С§р§л§Ц§Ы §·§г §Я§Ц§­§±§Ј§± (§в=0,01).

§µ§й§С§г§д§Я§Ъ§Ь§Ъ, §б§а§Э§е§й§С§У§к§Ъ§Ц §Ъ§Я§д§Ц§Я§г§Ъ§У§Я§е§р §д§Ц§в§С§б§Ъ§р §С§д§а§в§У§С§г§д§С§д§Ъ§Я§а§Ю, §й§С§л§Ц §Х§а§г§д§Ъ§Ф§С§Э§Ъ §и§Ц§Э§Ц§У§н§з §е§в§а§У§Я§Ц§Ы §·§г §­§±§Ї§± (<70 §Ю§Ф/§Х§Э), §ґ§Ф (<150 §Ю§Ф/§Х§Э), §й§Ц§Ю §Т§а§Э§о§Я§н§Ц, §б§в§Ъ§Я§Ъ§Ю§С§У§к§Ъ§Ц §г§д§С§Я§Х§С§в§д§Я§е§р §д§Ц§в§С§б§Ъ§р §б§в§С§У§С§г§д§С§д§Ъ§Я§а§Ю: §г§а§а§д§У§Ц§д§г§д§У§Ц§Я§Я§а 72,5% §б§в§а§д§Ъ§У 21,6% (§в<0,001), 74,4% §б§в§а§д§Ъ§У 56,3% (p<0,001). §°§Х§Я§С§Ь§а §д§а§Э§о§Ь§а 56% §б§С§и§Ъ§Ц§Я§д§а§У §Ф§в§е§б§б§н §Ъ§Я§д§Ц§Я§г§Ъ§У§Я§а§Ы §д§Ц§в§С§б§Ъ§Ъ §Х§а§г§д§Ъ§Ф§Э§Ъ §а§Т§а§Ъ§з §и§Ц§Э§Ц§У§н§з §е§в§а§У§Я§Ц§Ы §Э§Ъ§б§Ъ§Х§а§У, §Ъ §д§а§Э§о§Ь§а 35% §Ъ§Ю§Ц§Э§Ъ §д§в§Ъ §и§Ц§Э§Ц§У§н§з §б§С§в§С§Ю§Ц§д§в§С (§У§Ь§Э§р§й§С§с §е§в§а§У§Ц§Я§о §і-§в§Ц§С§Ь§д§Ъ§У§Я§а§Ф§а §Т§Ц§Э§Ь§С <2 §Ю§Ф/§Э).

§®§Ц§Ш§Х§е §д§Ц§Ю, §в§Ъ§г§Ь §Ь§а§Ю§Т§Ъ§Я§Ъ§в§а§У§С§Я§Я§а§Ы §Ь§а§Я§Ц§й§Я§а§Ы §д§а§й§Ь§Ъ §г§Я§Ъ§Ш§С§Э§г§с §Я§С 28% (§в=0,017) §б§в§Ъ §Я§С§Э§Ъ§й§Ъ§Ъ §Э§р§Т§а§Ф§а §а§Х§Я§а§Ф§а §и§Ц§Э§Ц§У§а§Ф§а §б§С§в§С§Ю§Ц§д§в§С, §Я§С 32% §б§в§Ъ §Я§С§Э§Ъ§й§Ъ§Ъ §Э§р§Т§н§з §Х§У§е§з §б§С§в§С§Ю§Ц§д§в§а§У (§в=0,007) §Ъ §Я§С 41% §б§в§Ъ §Х§а§г§д§Ъ§Ш§Ц§Я§Ъ§Ъ §У§г§Ц§з §д§в§Ц§з §и§Ц§Э§Ц§У§н§з §б§С§в§С§Ю§Ц§д§в§а§У (§в=0,002). 

§Ј§н§У§а§Х§н.

§µ §Т§а§Э§о§Я§н§з, §б§а§Э§е§й§С§р§л§Ъ§з §г§д§С§д§Ъ§Я§н §б§а§г§Э§Ц §°§¬§і, §г§Я§Ъ§Ш§Ц§Я§Ъ§Ц §ґ§Ф < 150 §Ю§Ф/§Х§Э §г§а§б§в§а§У§а§Ш§Х§С§Ц§д§г§с §Ю§Ц§Я§о§к§Ъ§Ю §в§Ъ§г§Ь§а§Ю §б§а§У§д§а§в§Я§н§з §Ь§а§в§а§Я§С§в§Я§н§з §г§а§Т§н§д§Ъ§Ы, §Я§Ц§Щ§С§У§Ъ§г§Ъ§Ю§а §а§д §е§в§а§У§Я§с §·§г §­§±§Ї§±. §±§а§Э§е§й§Ц§Я§Я§н§Ц §Х§С§Я§Я§н§Ц, §б§а§Э§С§Ф§С§р§д §С§У§д§а§в§н, §б§а§Х§Х§Ц§в§Ш§Ъ§У§С§р§д §Ь§а§Я§и§Ц§б§и§Ъ§р §Х§а§б§а§Э§Я§Ъ§д§Ц§Э§о§Я§а§Ф§а §г§Я§Ъ§Ш§Ц§Я§Ъ§с §ґ§Ф §б§а§г§Э§Ц §Х§а§г§д§Ъ§Ш§Ц§Я§Ъ§с §и§Ц§Э§Ц§У§н§з §е§в§а§У§Я§Ц§Ы §·§г §­§±§Ї§± §е §б§С§и§Ъ§Ц§Я§д§а§У, §б§Ц§в§Ц§Я§Ц§г§к§Ъ§з §°§¬§і.

Miller M., Cannon C.P., Murphy S.A. et al. Impact of Triglyceride Levels Beyond Low-Density Lipoprotein Cholesterol After Acute Coronary Syndrome in the PROVE IT-TIMI 22 Trial. J Am Coll Cardiol. February 19, 2008;51:724ЁC30. Medline §С§Т§г§д§в§С§Ь§д.

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