Введение и цель. Семейная гиперхолестеринемия (СГХС) распространенное наследственное заболевание, характеризующееся повышенным уровнем холестерина (ХС) липопротеидов низкой плотности (ЛНП) и преждевременным возникновением ишемической болезни сердца. Целью исследования была оценка частоты СГХС у пациентов с диагнозом острого коронарного синдрома (ОКС), поступивших в 2015 г. в клиники, участвующие в федеральном регистре ОКС. Материал и методы В анализ включены данные 924 лиц, из них 554 (60 ) мужчины, средний возраст 6512 лет, госпитализированных по поводу ОКС в 2015 г. При поступлении был выполнен сбор анамнеза для уточнения профиля риска и анализ крови с определением липидного профиля. Результаты Среди 924 пациентов, госпитализированных с диагнозом ОКС, частота возможной СГХС с уровнем общего ХС (ОХС) 7,5 ммоль/л и/или ХС ЛНП 5,0 ммоль/л составила 10 (n95), из них 35 (n33) лица моложе 60 лет артериальная гипертония диагностирована в 85 случаев, сахарный диабет 2-го типа у 15 участников, курение в настоящее время 20. Атеросклеротические сердечно-сосудистые заболевания (ССЗ) имели 65 (n62) человек, из них 24 (n23) лиц ранее перенесли инфаркт миокарда. Средний уровень ОХС составил 7,71,0 ммоль/л, ХС ЛНП 5,80,8 ммоль/л, триглицеридов 1,70,9 ммоль/л, ХС липопротеидов высокой плотности 1,10,2 ммоль/л. При поступлении только 4 (n4) принимали статины. При пересчете исходного уровня ХС ЛНП среди больных, получавших статины в общей группе, доля больных с потенциальной СГХС возросла до 15 (n140). Заключение. Частота возможной СГХС среди больных, госпитализированных по поводу ОКС в 2015 г. достигла 10, из них 2/3 уже имели атеросклеротические ССЗ. Таким образом, полученные результаты могут свидетельствовать о более высокой частоте СГХС среди пациентов, перенесших ОКС. Ключевые слова: регистр, острый коронарный синдром, гиперхолестеринемия, семейная гиперхолестеринемия , статины, холестерин липопротеидов низкой плотности.Aims. Familial Hypercholesterolemia (FH) is a hereditary common disorder that is characterized by elevated level of low-density lipoproteins cholesterol ((LDL-C) and premature coronary heart disease (CHD). The aim of the study was to estimate the frequency of FH among patients with acute coronary syndrome (ACS), admitted in 2015 to clinics participating in the federal ACS registry. Materials and methods: The database included 924 persons (554 (60) men, mean age 65 12 years), hospitalized with ACS in 2015. At the time of hospitalization for ACS were available medical history and lipid profile. Results: Among 924 patients hospitalized for ACS, the frequency of possible FH (total cholesterol level 7.5 mmol/l and/or LDL-C 5.0 mmol/l) was 10 (n95), of which 35 (n33) persons younger than 60 years hypertension is diagnosed in 85 of cases, diabetes mellitus in 15 of participants, smoking - 20. Atherosclerotic cardiovascular diseases (CVD) had 65 (n62) people, of whom 24 (n 23) had previously suffered myocardial infarction. The mean level of total cholesterol was 7.7 1.0 mmol/l, LDL-C was 5.8 0.8 mmol/l, triglycerides was 1.7 0.9 mmol/l, high-density lipoprotein cholesterol was 1,1 0.2 mmol/l. At the time of hospitalization only 4 (n4) used statins. When recalculating the baseline level of LDL cholesterol in patients who used statins in the general group, the part of patients with potential FH increased to 15 (n 140). Conclusion. The frequency of possible FH among patients hospitalized for ACS in 2015 reached 10, of which 2/3 already had atherosclerotic CVD. Therefore, the data may show a higher prevalence of FH in patients presenting with ACS.

Давно отмечено, что погодно-климатические факторы спо-собны влиять на здоровье человека. В ряде международных ис-следований выявлена сезонная цикличность заболеваемости и смертности от сердечно-сосудистых заболеваний (ССЗ) с пиком в холодное время года и минимумом в летний период [1][2][3]. Тем-пература воздуха и ее изменение являются наиболее значимым для сердечно-сосудистой системы погодным фактором. Графи-ческое изображение связи сердечно-сосудистой смертности со значениями температуры воздуха называется температурной кривой. В большинстве исследований температурные кривые смертности имеют V-или U-образную форму (см. рисунок), т.е. существует оптимальный диапазон температур, соответствую- The review summarizes epidemiologic data on the effects of heat on cardiovascular morbidity and mortality. Patients with heart failure and cardiac arrhythmias are most susceptible to negative heat exposure. At the same time, measures aimed at preserving the health of the population lead to a considerable reduction in losses associated with an abnormal rise in air temperature.

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The COVID-19 (COronaVIrus Disease 2019) pandemic caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2) continues to be a global threat to people and health systems. As of March 21, 2022, there are more than 460 million cases and more than 6 million deaths worldwide, and more than 17 million and 360,000 respectively in the Russian Federation. Due to the rapid spread of the new coronavirus infection, since the beginning of the pandemic, tremendous efforts have been made to create new pharmacological agents to reduce morbidity and mortality, and tactics have been used to repurpose existing medications in treatment regimens for patients with COVID-19, particularly statins. Statins represent one of the most widely used and prescribed classes of drugs in the world. The hypolipidemic properties of statins are actively used to treat hyperlipidemia and primary and secondary prevention of cardiovascular diseases and their complications. Statins have a known safety profile, are inexpensive and accessible. In addition to their hypolipidemic effects, statins have a wide range of pleiotropic anti-inflammatory, antiviral, and antithrombotic effects potentially useful in the treatment of COVID-19. Presumably, the use of statins can reduce SARS-CoV-2-induced organ and tissue damage and improve lung function. The use of statins, particularly atorvastatin, as one of the most effective, widely prescribed and studied drugs in this class, as a safe, affordable and relatively inexpensive therapy may be a promising therapeutic approach in the fight against a new coronavirus infection.

Aim. To study the frequency of prescriptions of various types of lipid-lowering therapy and their effectiveness in outpatient clinical practice based on the results of a questionnaire of primary care physicians.Material and methods. The study was performed in 2022 in 75 constituent entities of the Russian Federation with the participation of 1117 doctors working in outpatient clinics. Most of the doctors had work experience of 10-20 years or more. Doctors of polyclinics (therapists and cardiologists, etc.) before the start of the study received instructions, questionnaires for filling out, developed by the National Atherosclerosis Society. The frequency of prescriptions by primary care physicians of various types of lipid-lowering therapy and their effectiveness in terms of the frequency of achieving target levels of low-density lipoprotein cholesterol (LDL-C) was studied based on the results of a questionnaire.Results. Monotherapy with statins was prescribed in 55.2% of cases, free combination of rosuvastatin with ezetimibe – in 17.2%, single pill combination of rosuvastatin with ezetimibe – in 23.2%, combination therapy with PCSK9 inhibitors – in 4.1% of cases. Target levels of LDL-C ˂ 1.8 mmol/l and ˂ 1.4 mmol/l were achieved with statin monotherapy in 42.6% and 28.2% of cases, respectively, free combination of rosuvastatin with ezetimibe – in 61.7% and 39 .5%, a fixed combination of rosuvastatin with ezetimibe – in 67.8% and 48.5%, combination therapy with PCSK9 inhibitors – in 96.8% and 92.8% of cases.Conclusion. The single pill combination of rosuvastatin with ezetimibe is more effective in achieving target levels of LDL-C compared with statin monotherapy and therapy with free combination of statin with ezetimibe. Despite the fact that the target values of LDL-C when prescribing a combination with PCSK9 inhibitors were achieved in 96.8% and 92.8% of cases, they were used quite rarely at the outpatient stage of treatment in the Russian Federation.