rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2021-03-02rpcardio-2376Research ArticlePREVENTIVE CARDIOLOGY AND PUBLIC HEALTHПРОФИЛАКТИЧЕСКАЯ КАРДИОЛОГИЯ И ОБЩЕСТВЕННОЕ ЗДОРОВЬЕFeatures of Risk Stratification, Diagnosis and Secondary Prevention in Patients with Multifocal Arterial Disease. Part 2: Treatment OptionsОсобенности вторичной профилактики у пациентов с мультифокальным артериальным поражением. Часть 2: возможности леченияhttps://orcid.org/0000-0001-9397-4063ГрачевВ. Г.GrachevV. G.

Грачев Вадим Геннадьевич – кафедра факультетской терапии, эндокринологии, аллергологии и иммунологи, доцент, eLibrary SPIN 3097-0735.

Екатеринбург

Vadim G. Grachev - eLibrary SPIN 3097-0735

Yekaterinburg

grach_vad@mail.ruhttps://orcid.org/0000-0001-5219-9216ВеденскаяС. С.VedenskayaS. S.

Веденская Светлана Сергеевна – кафедра факультетской терапии, эндокринологии, аллергологии и иммунологи, доцент, eLibrary SPIN 5248-9958.

Екатеринбург

Svetlana S. Vedenskaya - eLibrary SPIN 5248-9958

Yekaterinburg

ssveden@yandex.ruhttps://orcid.org/0000-0002-0705-6651СмоленскаяО. Г.SmolenskayaO. G.

Смоленская Ольга Георгиевна - кафедра факультетской терапии, эндокринологии, аллергологии и иммунологи, профессор, зав. кафедрой, eLibrary SPIN 5443-9382

Екатеринбург

Olga G. Smolenskaya - eLibrary SPIN 5443-9382

Yekaterinburg

o.smolenskaya@mail.ruУральский государственный медицинский университетРоссияUrals State Medical UniversityRussian Federation202104052021172239248Copyright © Grachev V.G., Vedenskaya S.S., Smolenskaya O.G., 20212021Грачев В.Г., Веденская С.С., Смоленская О.Г.Grachev V.G., Vedenskaya S.S., Smolenskaya O.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2376

The similarity of the pathogenesis of atherosclerosis and atherothrombotic complications, regardless of their location, makes the approaches to secondary prevention similar, which include lifestyle modification, pharmacotherapy of hemodynamic disorders, metabolic changes and hemostasis. Secondary prophylaxis in patients with multifocal arterial lesions using antihypertensive, antithrombotic and lipid-lowering therapy provides a more pronounced decrease in the incidence of cardiovascular complications than in lesions of single vascular lesions due to a higher initial risk. However, these treatments do not reduce the risk to the level that is achieved by treating patients with less atherosclerotic lesion. In this regard, it is of interest to use the currently available new methods and regimens of drug therapy in patients with multifocal arterial lesions, which make it possible to more intensively influence the mechanisms of atherosclerosis progression and more effectively prevent the development of its complications.

Общность патогенеза атеросклероза и атеротромботических осложнений вне зависимости от их локализации делают схожими подходы ко вторичной профилактике, которые включают модификацию образа жизни, фармакотерапию гемодинамических нарушений, метаболических изменений и гемостаза. Учитывая более высокий исходный риск у пациентов с мультифокальным артериальным поражением (МФАП), вторичная профилактика с применением антигипертензивной, антитромботической и гиполипидемической терапии обеспечивает более выраженное снижение частоты сердечно-сосудистых осложнений, чем при поражениях отдельных сосудистых бассейнов. Однако эти мероприятия не позволяют снизить риск до уровня, который достигается при лечении пациентов с меньшей распространенностью атеросклероза. В связи с этим особый интерес представляет возможность применения у пациентов с МФАП появившихся в настоящее время новых методов и режимов медикаментозной терапии, позволяющих более интенсивно влиять на механизмы прогрессирования атеросклероза и эффективнее предупреждать развитие его осложнений.

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The authors declare that there are no conflicts of interest present.