nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2024-3-136-143nnp-2284Research ArticleREVIEWSОБЗОРЫLipoprotein(a) as a risk factor for cardiovascular diseases - focus on ischemic stroke (a position paper)Липопротеин(а) как фактор риска сердечно-сосудистых заболеваний: фокус на ишемический инсульт (позиционная статья)https://orcid.org/0000-0003-1955-1032СкибаЯ. Б.SkibaIa. B.

Скиба Ярослав Богданович.

197022, Санкт-Петербург, ул. Льва Толстого, 6-8

Iaroslav B. Skiba.

6-8, L'va Tolstogo St., St. Petersburg 197022

yaver-99@mail.comhttps://orcid.org/0000-0001-8699-2482ПолушинА. Ю.PolushinA. Yu.

197022, Санкт-Петербург, ул. Льва Толстого, 6-8

6-8, L'va Tolstogo St., St. Petersburg 197022

https://orcid.org/0000-0002-9850-1107СагановаЕ. С.SaganovaE. S.

197022, Санкт-Петербург, ул. Льва Толстого, 6-8

6-8, L'va Tolstogo St., St. Petersburg 197022

https://orcid.org/0000-0002-6141-486XСоколовА. С.SokolovA. S.

197022, Санкт-Петербург, ул. Льва Толстого, 6-8; 199034, Санкт-Петербург, наб. Макарова, 6

6-8, L'va Tolstogo St., St. Petersburg 197022; 6, Makarova Emb., St. Petersburg 199034

https://orcid.org/0000-0002-3231-6152ПоляковаЕ. А.PolyakovaE. A.

197022, Санкт-Петербург, ул. Льва Толстого, 6-8

6-8, L'va Tolstogo St., St. Petersburg 197022

https://orcid.org/0000-0002-6484-286XЯнишевскийС. Н.YanishevskiyS. N.

197341, Санкт-Петербург, ул. Аккуратова, 2

2, Akkuratova St., St. Petersburg 197341

https://orcid.org/0000-0001-7192-0961ВознюкИ. А.VosnyukI. A.

197022, Санкт-Петербург, ул. Льва Толстого, 6-8

6-8, L'va Tolstogo St., St. Petersburg 197022

ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава РоссииРоссияAcad. I.P. Pavlov First Saint Petersburg State Medical University of Ministry of Health of RussiaRussian FederationФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России; ФГБУН «Институт физиологии им. И.В. Павлова» Российской академии наукРоссияAcad. I.P. Pavlov First Saint Petersburg State Medical University of Ministry of Health of Russia; I.V. Pavlov Institute of Physiology, Russian Academy of ScienceRussian FederationФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииРоссияAlmazov National Medical Research Center, Ministry of Health of RussiaRussian Federation202422062024163136143Copyright © Skiba I.B., Polushin A.Y., Saganova E.S., Sokolov A.S., Polyakova E.A., Yanishevskiy S.N., Vosnyuk I.A., 20242024Скиба Я.Б., Полушин А.Ю., Саганова Е.С., Соколов А.С., Полякова Е.А., Янишевский С.Н., Вознюк И.А.Skiba I.B., Polushin A.Y., Saganova E.S., Sokolov A.S., Polyakova E.A., Yanishevskiy S.N., Vosnyuk I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2284

High lipoprotein(a) (LP(a)) level contributes as an independent risk factor to the development of cardiovascular diseases of atherosclerotic origin. The article contains data on the structural features of this particle, the genetic determination of its metabolism and content in blood plasma, and the pathogenic mechanisms of its proatherogenic, proinflammatory and prothrombotic effects. The authors analyzed epidemiological data on the frequency of elevated LP(a) levels in different population groups and its association with the risk of cardiovascular diseases. The data presented concern the indicators of LP(a) as a risk factor for the development of ischemic stroke (including recurrent stroke) and its individual pathogenetic subtypes, as well as the relationship between LP(a) levels and functional outcomes after cerebral accidents. Current recommendations for the treatment of patients with elevated LP(a) levels in the context of primary and secondary prevention of cardiovascular diseases are analyzed.

Повышенный уровень липопротеина(а) [Лп(а)] рассматривается как самостоятельный фактор риска развития сердечно-сосудистых заболеваний атеросклеротического генеза. В статье представлены данные об особенностях структуры данной частицы и генетической детерминированности ее метаболизма и уровня в плазме крови, а также о патогенетических механизмах реализации ее проатерогенного, провоспалительного и протромботического эффектов. Авторами проанализированы эпидемиологические данные о частоте встречаемости повышенного уровня Лп(а) в разных популяциях, а также взаимосвязь с риском развития сердечно-сосудистых осложнений. Представлены данные, касающиеся роли Лп(а) как фактора риска развития ишемического инсульта (включая повторный) и отдельных его патогенетических подтипов, ассоциации между уровнем Лп(а) и функциональными исходами после церебральных катастроф. Проанализированы современные рекомендации по ведению пациентов с повышенным уровнем Лп(а) в рамках первичной и вторичной профилактики сердечно-сосудистых осложнений.

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