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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">evrazkar</journal-id><journal-title-group><journal-title xml:lang="ru">Евразийский Кардиологический Журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Eurasian heart journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2225-1685</issn><issn pub-type="epub">2305-0748</issn><publisher><publisher-name>Евразийская ассоциация кардиологов</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.38109/2225-1685-2018-3-62-75</article-id><article-id custom-type="elpub" pub-id-type="custom">evrazkar-300</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW</subject></subj-group></article-categories><title-group><article-title>ВРЕМЕННЫЕ ФАКТОРЫ, ВЛИЯЮЩИЕ НА ЭФФЕКТИВНОСТЬ И ПЕРЕНОСИМОСТЬ ПРИМЕНЕНИЯ СТАТИНОВ: НАУЧНЫЕ И ПРАКТИЧЕСКИЕ АСПЕКТЫ</article-title><trans-title-group xml:lang="en"><trans-title>TIME-DEPENDENT FACTORS OF EFFECTIVENESS AND TOLERABILITY OF STATINS: SCIENTIFIC AND PRACTICAL ASPECTS</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гиляревский</surname><given-names>С. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Giliarevskii</surname><given-names>S. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор кафедры клинической фармакологии и терапии</p><p>тел. +7(495)945-70-90</p></bio><bio xml:lang="en"><p>MD, Professor of the Department of Clinical Pharmacology and Therapy, </p><p>Barrikadnaya Str., 2/1, Building 1, Moscow, Russia,123242</p><p>Tel. +7(495)945-70-90</p></bio><email xlink:type="simple">sgilarevsky@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение дополнительного профессионального образования Российская медицинская академия непрерывного профессионального образования Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal state-funded educational institution of Additional Professional Education Russian medical academy of continuous professional education Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>30</day><month>09</month><year>2018</year></pub-date><volume>0</volume><issue>3</issue><fpage>62</fpage><lpage>75</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Гиляревский С.Р., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Гиляревский С.Р.</copyright-holder><copyright-holder xml:lang="en">Giliarevskii S.R.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.heartj.asia/jour/article/view/300">https://www.heartj.asia/jour/article/view/300</self-uri><abstract><p>В статье рассматриваются современные подходы к анализу эффективности вмешательств в зависимости от времени, т.е. от продолжительности периода после начала их применения. Обсуждается роль анализа кривых Каплана-Мейера для оценки эффектов сравниваемых вмешательств в зависимости от времени. Рассматриваются различные варианты взаимного расположения кривых Каплана-Мейера в ходе выполнения исследования. Приводятся результаты недавно выполненного анализа, посвященного оценке продолжительности периода между началом приема статинов и развитием клинических преимуществ терапии. В том числе обсуждается возможность использования показателя продолжительности периода до развития преимуществ (ППРП) вмешательства и показателя продолжительности периода до развития вреда (ППРВ), обусловленного вмешательством, при принятии клинического решения об обоснованности выбора определенного метода лечения, в частности показателя ЧБНЛ. Приводятся мнения, подчеркивающие важность оценки эффективности вмешательств с помощью абсолютного, а не относительного риска развития неблагоприятных клинических исходов. Рассматриваются клинические ситуации, в которых имеет особое значение продолжительность периода до развития клинического эффекта, в частности у больных с очень высоким риском развития осложнений сердечно-сосудистых заболеваний (например, после острого коронарного синдрома) и у больных, у которых в большинстве случаев ограничена продолжительность жизни. Подчеркивается роль применения аторвастатина в клинических ситуациях, при которых имеет значение более раннее достижение клинических преимуществ гиполипидемической терапии. Приводятся данные о роли применения статинов, в частности аторвастатина, в ранние сроки после развития острого коронарного синдрома.</p></abstract><trans-abstract xml:lang="en"><p>The article considers modern approaches to analyzing the effectiveness of interventions in relation to time, that is, the length of the period after the beginning of their application. The role of the analysis of the Kaplan-Meier curves for the evaluation of the effects of compared interventions depending on the time is discussed. Various options of the relative layout of the Kaplan-Meier curves in the course of the study are examined. The results of a recent analysis of the duration of the period between the onset of statin use and the development of clinical benefits of therapy are presented. In particular, the possibility of using the TTB indicator of intervention and TTH indicator, caused by the intervention, is discussed in making a clinical decision about the validity of the choice of a particular treatment method, in particular the indicator of number of patients Analysis of the Kaplan-Meier curves as an approach to assessing the effectiveness of therapy Modern effective clinical practice largely depends not only on the clinical experience of the physician, but also on the skills of searching and evaluating the evidence-based information that allows to choose the optimal treatment strategy. Such tactics can be determined only in the course of large and well-planned randomized clinical trials (RCTS). Analysis of the survival curves constructed using the Kaplan-Meier method has become one of the main approaches to assessing the incidence of adverse outcomes in modern clinical trials. There may be several variants of the "behavior" of such curves [<xref ref-type="bibr" rid="cit1">1</xref>]. Such curves may not diverge throughout the study period (Figure 1A), indicating that there is no difference between the efficacy and / or safety of the interventions compared. Such curves may diverge, which will indicate a difference between the who need to be treated with a particular drug. Opinions that emphasize the importance of evaluating the effectiveness of interventions with absolute rather than relative risk of adverse clinical outcomes are mentioned. Clinical situations in which the duration of the TTB is of particular importance, in particular, in patients with a very high risk of developing complications of cardiovascular diseases (for example, after an acute coronary syndrome) and in patients who in most cases have limited life expectancy are considered. The role of atorvastatin in clinical situations is emphasized, in which the earlier achievement of the clinical advantages of lipid-lowering therapy is important. Data on the role of statins, in particular atorvastatin, are given in the early stages after the development of acute coronary syndrome.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>временные факторы</kwd><kwd>кривые Каплана-Мейера</kwd><kwd>аторвастатин</kwd><kwd>сердечно-сосудистые заболевания</kwd></kwd-group><kwd-group xml:lang="en"><kwd>time factors</kwd><kwd>Kaplan-Meier curves</kwd><kwd>atorvastatin</kwd><kwd>cardiovascular diseases</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Статья подготовлена при финансовой поддержке компании Пфайзер, что никоим образом не повлияло на собственное мнение автора.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Malkin C.J., Channer K.S. Life-saving or life-prolonging? Interpreting trial data and survival curves for patients with congestive heart failure. 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