Correction of lipidemic, hemostasiological disorders and remodeling of arteries of the brachiocephalic trunk in patients with a very high risk of death from cardiovascular diseases

Abstract

Purpose of work. To study the features of the clinical picture of ischemic heart disease, lipidemic, hemostasiological disorders and remodeling of the arteries of the brachiocephalic trunk in patients with a very high risk of death from cardiovascular diseases, as well as the possibility of correcting the revealed changes using statin therapy. Material and methods. The study included 116 patients with coronary artery disease aged 54.7 ± 3.5 years. The state of the hemostasis system (fibrinogen, D-dimer, time of the onset of ADP-induced platelet aggregation) and endothelial dysfunction (von Willebrand factor), determination of the lipid spectrum, ultrasound triplex scanning of BCS arteries were assessed. Results. During 24-week treatment with atrovastatin, there is a decrease in the level of low-density lipoprotein cholesterol, total cholesterol and triglycerides, von Willebrand factor, D-dimer, fibrinogen, an increase in the level of high-density lipoprotein cholesterol, the time of the onset of ADP-induced platelet aggregation (p <0.05) ... Against the background of treatment with rosuvastatin for 24 weeks, there is a decrease in the level of low-density lipoprotein cholesterol, total cholesterol and triglycerides, von Willebrand factor, D-dimer, fibrinogen, and an increase in the onset time of ADP-induced platelet aggregation (p <0.05). The cross-sectional area of ​​the lumen of the internal carotid artery on the left with atorvastatin increased on average by 25.6% (p <0.05). The cross-sectional area of ​​the lumen of the right internal carotid artery during therapy with rosuvastatin increased on average by 21.6% (p <0.05). Conclusion. The inclusion of statins in the complex therapy of coronary artery disease for 24 weeks leads to an improvement in the clinical condition of patients, the achievement of target levels of lipid metabolism, a decrease in the severity of endothelial dysfunction and thrombogenic potential of the blood, and, in some cases, slows down the progression of atherosclerosis of the arteries of the BCS.