Cor Vasa 2010, 52(4):212-228 | DOI: 10.33678/cor.2010.056

Residual Risk Reduction Initiative: výzva ke snížení reziduálního vaskulárního rizika u pacientů s dyslipidemií

Jean-Charles Fruchart, Frank M. Sacks, Michel P. Hermans, Gerd Assmann, W. Virgil Brown, Richard Ceska, M. John Chapman, Paul M. Dodson, Paola Fioretto, Henry N. Ginsberg, Takashi Kadowaki, Jean-Marc Lablanche, Nikolaus Marx, Jorge Plutzky, Zeljko Reiner, Robert S. Rosenson, Bart Staels, Jane K. Stock, Rody Sy, Christoph Wanner, Alberto Zambon, Paul Zimmet

Navzdory současným standardům léčby zaměřené na dosažení cílových hodnot LDL cholesterolu, krevního tlaku a glykemie mají pacienti s dyslipidemií vysoké reziduální riziko vzniku vaskulárních příhod. Aterogenní dyslipidemie, zejména vyšší hodnota triglyceridů a nízká koncentrace HDL cholesterolu, se často vyskytuje spolu s vyšší koncentrací apolipoproteinu B a non-HDL cholesterolu u pacientů s diagnostikovanými kardiovaskulárními onemocněními, diabetes mellitus 2. typu, obezitou nebo metabolickým syndromem a je spojena s reziduálním makrovaskulárním a mikrovaskulárním rizikem. Residual Risk Reduction Initiative (R3i) byla založena proto, aby se touto důležitou problematikou zabývala.
Cílem tohoto souhrnného přehledu je vyzdvihnout skutečnost, že se aterogenní dyslipidemie podílí na reziduálním makrovaskulárním riziku a mikrovaskulárních komplikacích, a doporučit léčebnou intervenci vedoucí ke snížení tohoto rizika, podpořenou důkazy a odborným konsensem. Důležitým prvním krokem je úprava životního stylu. Často je mimo to nutná také farmakoterapie. Přidání niacinu, fibrátu nebo ω-3 mastných kyselin k terapii statiny zlepšuje všechny lipidové rizikové faktory. Klinické studie hodnotí, zda mají tyto strategie lepší klinický přínos než léčba statiny. Závěrem lze říci, že iniciativa R3i zdůrazňuje potřebu ovlivnit vysokou míru reziduálního vaskulárního rizika u pacientů s dyslipidemií, kteří jsou léčeni prostřednictvím úpravy životního stylu anebo farmakoterapií v souladu se současnými standardy léčby.

Keywords: Životní styl; Makrovaskulární komplikace; Mikrovaskulární komplikace; Farmakoterapie; Reziduální riziko

Published: April 1, 2010  Show citation

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Fruchart J, Sacks FM, Hermans MP, Assmann G, Virgil Brown W, Ceska R, et al.. Residual Risk Reduction Initiative: výzva ke snížení reziduálního vaskulárního rizika u pacientů s dyslipidemií. Cor Vasa. 2010;52(4):212-228. doi: 10.33678/cor.2010.056.
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