Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC21110.15690/vramn.v68i2.545CARDIOVASCULAR SURGERY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ СЕРДЕЧНО-СОСУДИСТОЙ ХИРУРГИИPREVENTION OF CARDIOVASCULAR COMPLICATIONS IN PATIENTS UNDERGOING AORTIC-ILIAC RECONSTRUCTIONS BY CORRECTION OF INFLAMMATION AND ENDOTOXEMIAПРОФИЛАКТИКА КАРДИАЛЬНЫХ ОСЛОЖНЕНИЙ ПРИ ВЫПОЛНЕНИИ АОРТОПОДВЗДОШНЫХ РЕКОНСТРУКЦИЙ ПОСРЕДСТВОМ КОРРЕКЦИИ ВОСПАЛЕНИЯ И ЭНДОТОКСЕМИИMedvedevaE. A.МедведеваЕ. А.
Russian Federation

PhD, Assistant, Department of Propaedeutic Therapy Samara State Medical University Address: 443099, Samara, Chapaevskaya St., 89; tel.: (846) 276-78-37

elena5583@mail.ruShchukinYu. V.ЩукинЮ. Щ.
Russian Federation

Professor, Head of the Department of Propaedeutic Therapy, Samara State Medical University Address: 443099, Samara, Chapaevskaya St., 89; tel.: (846) 276-78-37

samgmu_pt@mail.ruSeleznevE. I.СелезневЕ. И.
Russian Federation

PhD, Assistant, Department of Propaedeutic Therapy Samara State Medical University Address: 443099, Samara, Chapaevskaya St., 89; tel.: (846) 995-90-33

sonteg@mail.ruSamara State Medical University, Russian FederationСамарский государственный медицинский университет, Российская Федерация22022013682Vestnik Rossiiskoi akademii medetsinskikh nauk / Annals of the Russian academy of medical sciencesВестник Российской академии медицинских наук242807082015Copyright ©; 1970, "Paediatrician" Publishers LLCCopyright ©; 1970, Издательство "Педиатръ"1970"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/211

There were presented the results of examination and treatment of 130 patients with atherosclerosis. Objective is to study the role of atorvastatin in correction of inflammation, endotoxemia and prevention of cardiovascular complications in patients with atherosclerosis undergoing aorto-iliac reconstruction. There were observed initial and postoperative activation of inflammation, endotoxemia in patients with multifocal atherosclerosis. We found that short-term therapy with atorvastatin 60 mg per day had a significant advantage over low-dose in correction of pre- and postoperative endogenous inflammation, endotoxemia and prevention of cardiac events after aorto-iliac reconstruction.

В работе представлены результаты обследования и лечения 130 пациентов с атеросклерозом. Цель состояла в оптимизации предоперационной подготовки больных атеросклерозом путем коррекции эндогенной интоксикации и воспаления аторвастатином для профилактики периоперационных кардиальных осложнений при аортоподвздошных реконструкциях. Установлена исходная и послеоперационная активация воспаления и интоксикации у больных с мультифокальным атеросклерозом. Показано, что кратковременная терапия аторвастатином в дозе 60 мг в сут имеет значимое преимущество перед низкодозовой в коррекции пред- и послеоперационного эндогенного воспаления, интоксикации и в профилактике кардиальных осложнений при выполнении аортоподвздошных реконструкций.

atherosclerosisaorto-iliac reconstructioninflammationendotoxemiaatorvastatinатеросклерозаортоподвздошные реконструкциивоспалениеэндотоксемияаторвастатин1. Kazakov A.Yu. Diagnostika i taktika lecheniya bol'nykh s okklyuziruyushchimi porazheniyami bryushnoi aorty i arterii nizhnikh konechnostei pri nalichii sochetannoi IBS. Avtoref. diss. … dokt. med. nauk [Diagnosis and treatment strategy in patients with occlusive lesions of the abdominal aorta and lower extremity arteries in the presence of concomitant coronary artery disease. Author’s abstract]. Moscow, 2009. 46 p.2. Pokrovskii A.V., Kuntsevich G.I., Zotikov A.E., Golovyuk A.L., Burtseva E.A., Ivanov L.O., Suntsov D.S. The use of rosuvastatin in the prevention of cardiac complications in the surgical treatment of patients with vascular pathology. Angiologiya i sosudistaya khirurgiya – Angiology and Vascular Surgery. 2009; 15 (3): 9–13.3. Ridker P.M., Cannon C. P., Morrowet D., Rifai N., Rose L.M., McCabe C.H., Pfeffer M.A., Braunwald E. Pravastatin or atorvastatin evaluation and infection therapy-thrombolysis in myocardial infarction 22 (PROVE IT-TIMI 22) investigators C-reactive protein levels and outcomes after statin therapy. N. Engl. J. Med. 2005; 352: 20–28.4. Arshinov A.V., Maslova I.G. The role of infection and inflammation in the development of atherosclerosis (review). Angiologiya i sosudistaya khirurgiya = Angiology and Vascular Surgery. 2011; 17 (1): 35–41.5. Gavrilenko A.V., Voronov D.A., Kochetov C.V. Forecasting results of arterial reconstructions and the likelihood of progression of atherosclerosis based on the level of plasma cytokines. Angiologiya i sosudistaya khirurgiya = Angiology and Vascular Surgery. 2010; 16 (3): 146–151.6. Polyantsev A.A., Mozgovoi P.V., Frolov D.V., Novochadov V.V., Spel'chuk A.M. Evaluation of the prognostic significance of morphometric parameters of inflammation of the vascular wall in relation to long-term results of reconstructive surgery in aortoiliac zone. Angiologiya i sosudistaya khirurgiya = Angiology and Vascular Surgery. 2011; 17 (1): 42–46.7. Chan Y.C., Cheng S.W., Irwin M.G. Perioperative use of statins in noncardiac surgery. Vasc. Health Risk Manag. 2008; 4 (1): 75–81.8. Gavrilov V.B., Lobko N.F., Gavrilova A.R., Konev S.V. Determination of tyrosine peptides in blood plasma with the correction of background absorption. The sharp increase in sensitivity of the test to intoxication. Klinicheskaya i laboratornaya diagnostika = Clinical and laboratory diagnosis. 2004; 6: 19–22.9. Pearson T.A., Mensah G.A., Alexander R.W., Anderson J.L., Cannon R.O. 3rd, Criqui M., Fadl Y.Y., Fortmann S.P., Hong Y., Myers G.L., Rifai N., Smith S.C. Jr, Taubert K., Tracy R.P., Vinicor F.; Centers for Disease Control and Prevention; American Heart Association. Markers of inflammation and cardiovascular disease: application to clinical and public health practice — a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003; 107: 499–511.10. Kajinami K., Kawai Y. C-reactive protein; new evidence for another inflammatory biomarker predicting cardiovascular disease risk. Atherosclerosis. 2011; 214: 39–40.11. Holvoet P., Keyzer D. De, Jacobs D.R. Oxidized LDL and the metabolic syndrome. Future Lipidol. 2008; 3 (6): 637–649.12. Federici M., Menghini R. s-PLA2: linking atherosclerosis to aneurism progression. Atherosclerosis. 2011; 214: 41–42.13. Tutunov V.S., Popkova T.V., Novikova D.S., Nasonov E.L., Kukharchuk V.V. Comparative evaluation of anti-inflammatory activity by high-low and applications of atorvastatin in coronary heart disease and rheumatoid arthritis. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular therapy and prevention. 2008; 7: 43–48.14. Shval'b P.G., Kalinin R.E. Some biochemical changes in the blood of patients with atherosclerosis obliterans of lower limb arteries before and after surgery. Angiologiya i sosudistaya khirurgiya = Angiology and Vascular Surgery. 2007; 13 (3): 34–36.