POSSIBILITIES OF RESIDUAL DYSLIPIDEMIA CORRECTION IN PATIENTS WITH MULTIFOCAL ATHEROSCLEROSIS, WHO ARE RECEIVING OPTIMAL STATIN THERAPY

Background. Patients with multifocal atherosclerosis with maximal cardiovascular risk are at special place in the context of lipid-lowering therapy optimization. These patients require residual dyslipidemia correction to the fullest extent possible. Materials and methods. Effects of medication Vasosponine (ZAO “Vifitekh”, Russia) which is a source of vegetal saponins in a dosage 400 mg per day on serum lipid profile parameters were evaluated in patients with multifocal atherosclerosis and non-target levels of atherogenic lipoproteins while receiving optimal statin treatment. The study included 100 patients with stable coronary artery disease and high cardiovascular risk with an experience of myocardial infarction or percutaneous coronary intervention in the last 2-12 months and diagnosed with obliterating atherosclerosis of peripheral arteries - brachiocephalic arteries and/or lower extremities arteries. Study group (n=50) included patients who received combined lipid-lowering therapy: atorvastatin in dosage 40 mg per day + Vasosponine 400 mg per day along with baseline treatment. Control group included 50 patients receiving only atorvastatin in dosage 40 mg per day along with baseline treatment. Total duration of the study was 6 months: with screening for 30 days and patient follow-up for 90 days. The study included 3 endpoints at 1 st, 10th, and 90th days of treatment. Results. It was shown that adding of Vasosponine to treatment allows results in significant and stable decrease of total cholesterol level by 30.7% (p<0.001), low-density lipoprotein level by 37.2% (p<0.001), triglycerides level by 37.0% (p<0.0001), and atherogenic index by 39.5% after 90 days of treatment. Vasosponine was established to have good safety profile. Conclusion. Medications containing vegetal saponins may be used in escalation schemes of lipid-lowering therapy in patients who did not achieve target levels of lipids after treatment with optimal statin doses.

dyslipidemia, atherosclerosis, lipoproteins, atherogenic coefficient, vegetable saponins, Vazosponin