Липопротеин(а) как фактор риска сердечно-сосудистых заболеваний: фокус на ишемический инсульт (позиционная статья)

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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