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evrazkar

Евразийский Кардиологический Журнал

Eurasian heart journal

2225-16852305-0748

Евразийская ассоциация кардиологов

10.38109/2225-1685-2025-2-6-34

evrazkar-6515

Research Article

КЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИ

CLINICAL GUIDELINES

Клинические рекомендации Евразийской ассоциации кардиологов (ЕАК)/ Национального общества по изучению атеросклероза (НОА) по диагностике и коррекции нарушений липидного обмена с целью профилактики и лечения атеросклероза (2025)

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Ежов

М. В.

Ezhov

M. V.

Марат Владиславович Ежов, д.м.н., профессор, главный научный сотрудник, руководитель лаборатории нарушений липидного обмена, отдел проблем атеросклероза, Институт клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, д. 15 а, Москва 121552

телефон: +7-495-414-60-67

Marat V. Ezhov, Dr. of Sci. (Med.), Professor, Chief Researcher, Head of the Laboratory of Lipid Metabolism Disorders, Department of Atherosclerosis Problems, A.L. Myasnikov Institute of Clinical Cardiology

marat_ezhov@mail.ru

https://orcid.org/0000-0002-7028-362X

Кухарчук

В. В.

Kukharchuk

V. V.

Валерий Владимирович Кухарчук, член-корреспондент РАН, д.м.н., профессор, главный научный сотрудник, руководитель отдела проблем атеросклероза, Институт клинической кардиологии им. А.Л. Мясникова

Valery V. Kukharchuk, Corresponding Member of the Russian Academy of Sciences, Dr. of Sci. (Med.), Professor, Chief Researcher, Head of the Department of Atherosclerosis Problems, A.L. Myasnikov Institute of Clinical Cardiology

https://orcid.org/0000-0002-7273-6979

Балахонова

Т. В.

Balakhonova

T. V.

Татьяна Валентиновна Балахонова, д.м.н., профессор, главный научный сотрудник, руководитель лаборатории ультразвуковых методов исследования сосудов, Институт клинической кардиологии им. А.Л. Мясникова

Tatyana V. Balakhonova, Dr. of Sci. (Med.), Professor, Chief Researcher, Head of the Laboratory of Ultrasound Methods for Vascular Research, A.L. Myasnikov Institute of Clinical Cardiology

https://orcid.org/0000-0002-6815-444X

Гуревич

В. С.

Gurevich

V. S.

Виктор Савельевич Гуревич, д.м.н., профессор кафедры госпитальной терапии и кардиологии; заведующий отделом атеросклероза Центра «Кардиология»

Victor S. Gurevich (St. Petersburg, Dr. of Sci. (Med.), Professor, Chair of Internal Medicine and Cardiology; The Head of the Department of Atherosclerosis, Сenter of Cardiology

https://orcid.org/0000-0003-1534-3965

Сергиенко

И. В.

Sergienko

I. V.

Игорь Владимирович Сергиенко, д.м.н., доцент, главный научный сотрудник, руководитель лаборатории фенотипов атеросклероза, Институт клинической кардиологии им. А.Л. Мясникова

Igor V. Sergienko, Dr. of Sci. (Med.), Associate Professor, Chief Researcher, Head of the Laboratory of Atherosclerosis Phenotypes, A.L. Myasnikov Institute of Clinical Cardiology

https://orcid.org/0000-0001-7004-0903

Соколов

А. А.

Sokolov

A. A.

Алексей Альбертович Соколов, д.м.н., профессор, заведующий кабинетом экстракорпоральной гемокоррекции и фотогемотерапии, врач-трансфузиолог, Институт клинической кардиологии им. А.Л. Мясникова

Alexey A. Sokolov, Dr. of Sci. (Med.), Professor, Head of the Extracorporeal Hemocorrection and Photohemotherapy Department, Transfusiologist, A.L. Myasnikov Institute of Clinical Cardiology

https://orcid.org/0000-0002-3786-9995

Семенкин

А. А.

Semenkin

A. A.

Александр Анатольевич Семенкин, д.м.н., профессор, профессор кафедры внутренних болезней и семейной медицины дополнительного профессионального образования

Alexander A. Semenkin, Dr. of Sci. (Med.), Professor, Department of Internal Medicine and Family Medicine, Continuing Professional Education

https://orcid.org/0000-0002-7731-7730

Шапошник

И. И.

Shaposhnik

I. I.

Игорь Иосифович Шапошник, д.м.н., профессор, заведующий кафедрой

Igor I. Shaposhnik, Head of Department

https://orcid.org/0000-0003-3417-0895

Ахмеджанов

Н. М.

Akhmedzhanov

N. M.

Надир Мигдатович Ахмеджанов, к.м.н., ведущий научный сотрудник, отдел профилактики метаболических нарушений

Nadir M. Akhmedzhanov, Cand. of Sci. (Med.), Leading Researcher, Department of Prevention of Metabolic Disorders

https://orcid.org/0000-0002-4642-3610

Барбараш

О. Л.

Barbarash

O. L.

Ольга Леонидовна Барбараш, академик РАН, д.м.н., профессор, директор

Olga L. Barbarash, Academician of the Russian Academy of Sciences, Dr. of Sci. (Med.), Professor, Director

https://orcid.org/0000-0003-2250-5942

Бубнова

М. Г.

Bubnova

M. G.

Марина Геннадьевна Бубнова, д.м.н., профессор, руководитель отдела реабилитации и вторичной профилактики сердечно-сосудистых заболеваний

Marina G. Bubnova, Dr. of Sci. (Med.), Professor, Head of the Department of Rehabilitation and Secondary Prevention of Cardiovascular Diseases

https://orcid.org/0000-0001-9425-413X

Воевода

М. И.

Voevoda

M. I.

Михаил Иванович Воевода, академик РАН, д.м.н., профессор, директор

Mikhail I. Voevoda, Academician of the Russian Academy of Sciences, Dr. of Sci. (Med.), Professor, Head

https://orcid.org/0000-0002-4510-6197

Галявич

А. С.

Galyavich

A. S.

Альберт Сарварович Галявич, академик АН РТ, д.м.н., профессор, заведующий кафедрой кардиологии

Albert S. Galyavich, Academician of the Academy of Sciences of the Republic of Tatarstan, Dr. of Sci. (Med.), Professor, Head

https://orcid.org/0009-0003-5032-170X

Ерёгин

С. Я.

Eregin

S. Ya.

Сергей Янович Ерёгин, к.м.н., руководитель, Институт непрерывного профессионального образования, Образовательный медицинский центр

Sergey Ya. Eregin, Cand. of Sci. (Med.), Head of the Institute of Continuous Professional Education, Educational Medical Center

Коновалов

Г. А.

Konovalov

G. A.

Геннадий Александрович Коновалов, д.м.н., профессор, руководитель

Gennady A. Konovalov, Dr. of Sci. (Med.), Professor, Head

https://orcid.org/0000-0003-2231-4695

Корнева

В. А.

Korneva

V. A.

Виктория Алексеевна Корнева, к.м.н., доцент, кафедра факультетской терапии, фтизиатрии, инфекционных болезней и эпидемиологии

Victoria A. Korneva, Cand. of Sci. (Med.), Associate Professor, Department of Faculty Therapy, Phthisiology, Infectious Diseases and Epidemiology

https://orcid.org/0000-0001-5944-6427

Покровский

С. Н.

Pokrovsky

S. N.

Сергей Николаевич Покровский, д.б.н., профессор, главный научный сотрудник, руководитель лаборатории проблем атеросклероза, Институт экспериментальной кардиологии

Sergei N. Pokrovsky, Dr. of Sci. (Biol.), Professor, Chief Researcher, Head of the Laboratory of Atherosclerosis Problems, Institute of Experimental Cardiology

https://orcid.org/0000-0003-0522-767X

Раскуражев

А. А.

Raskurazhev

A. A.

Антон Алексеевич Раскуражев, к.м.н., старший научный сотрудник, врач-невролог высшей категории

Anton A. Raskurazhev, Cand. of Sci. (Med.), Senior Researcher, neurologist of the highest category

https://orcid.org/0000-0002-7750-7358

Скибицкий

В. В.

Skibitsky

V. V.

Виталий Викентьевич Скибицкий, д.м.н., профессор, заведующий кафедрой госпитальной терапи

Vitaly V. Skibitsky, Dr. of Sci. (Med.), Professor, Head of the Department of Hospital Therapy

https://orcid.org/0000-0002-5883-8119

Танашян

М. М.

Tanashyan

M. M.

Маринэ Мовсесовна Танашян, член-корреспондент РАН, д.м.н., профессор, заместитель директора по научной работе

Marine M. Tanashyan, Corresponding Member of the Russian Academy of Sciences, Dr. of Sci. (Med.), Professor, Deputy Director for Research

https://orcid.org/0000-0002-9822-4357

Чазова

И. Е.

Chazova

I. E.

Ирина Евгеньевна Чазова, академик РАН, д.м.н., профессор, заместитель генерального директора по научно-экспертной работе, руководитель отдела системных гипертензий, Институт клинической кардиологии им. А.Л. Мясникова

Irina E. Chazova, Academician of the Russian Academy of Sciences, Dr. of Sci. (Med.), Professor, Deputy General Director for Scientific and Expert Work, Head of Hypertension Department, A.L. Myasnikov Institute of Clinical Cardiology

https://orcid.org/0000-0002-4413-5068

Филиппов

А. Е.

Filippov

A. E.

Александр Евгеньевич Филиппов, д.м.н., профессор, кафедра госпитальной терапии

Alexander E. Filippov, Dr. of Sci. (Med.), Professor, Department of Hospital Therapy

https://orcid.org/0000-0003-2760-2792

Чубыкина

У. В.

Chubykina

U. V.

Ульяна Валериевна Чубыкина, к.м.н., младший научный сотрудник, лаборатория нарушений липидного обмена, Институт клинической кардиологии им. А.Л. Мясникова

Uliana V. Chubykina, Cand. of Sci. (Med.), Junior Researcher, Laboratory of Lipid Metabolism Disorders, A.L. Myasnikov Institute of Clinical Cardiology

https://orcid.org/0000-0002-1394-3791

Якушин

С. С.

Yakushin

S. S.

Сергей Степанович Якушин, д.м.н., профессор, заведующий кафедрой госпитальной терапии

Sergey S. Yakushin, Dr. of Sci. (Med.), Professor, Head of the Department of Hospital Therapy

ФГБУ «Национальный медицинский исследовательский центр кардиологии им. Е.И. Чазова» Минздрава РоссииРоссияE.I. Chazov National Medical Research Center of CardiologyRussian Federation

Северо-западный государственный медицинский университет им. И.И.Мечникова; Санкт-Петербургский государственный университетРоссияMechnikov’s North-west State Medical University; St. Petersburg State UniversityRussian Federation

Омский государственный медицинский университетРоссияOmsk State Medical UniversityRussian Federation

Южно-Уральский государственный медицинский университетРоссияSouth Ural State Medical UniversityRussian Federation

ФГБУ «Национальный медицинский исследовательский центр терапии и профилактической медицины» Минздрава РоссииРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian Federation

ФГБНУ «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний» Министерства науки и высшего образования Российской ФедерацииРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation

Федеральный исследовательский центр фундаментальной и трансляционной медициныРоссияFederal Research Center for Fundamental and Translational MedicineRussian Federation

ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава РоссииРоссияDepartment of CardiologyRussian Federation

Ярославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian Federation

Центр диагностики и инновационных медицинских технологий КДЦ МЕДСИРоссияCenter for Diagnostics and Innovative Medical Technologies of the MEDSI Clinical Diagnostic CenterRussian Federation

ФГБОУ ВО «Петрозаводский государственный университет»РоссияPetrozavodsk State UniversityRussian Federation

ФГБНУ «Научный центр неврологииРоссияScientific Center of NeurologyRussian Federation

ФГБОУ ВО «КГМУ» Минздрава РоссииРоссияKuban State Medical UniversityRussian Federation

ФГБНУ «Научный центр неврологии»РоссияScientific Center of NeurologyRussian Federation

Санкт-Петербургский Государственный университетРоссияSaint Petersburg State UniversityRussian Federation

Рязанский государственный медицинский университет имени академика И.П. ПавловаРоссияI.P. Pavlov Ryazan State Medical UniversityRussian Federation

2025

02062025

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Copyright © Ежов М.В., Кухарчук В.В., Балахонова Т.В., Гуревич В.С., Сергиенко И.В., Соколов А.А., Семенкин А.А., Шапошник И.И., Ахмеджанов Н.М., Барбараш О.Л., Бубнова М.Г., Воевода М.И., Галявич А.С., Ерёгин С.Я., Коновалов Г.А., Корнева В.А., Покровский С.Н., Раскуражев А.А., Скибицкий В.В., Танашян М.М., Чазова И.Е., Филиппов А.Е., Чубыкина У.В., Якушин С.С., 2025

2025

Ежов М.В., Кухарчук В.В., Балахонова Т.В., Гуревич В.С., Сергиенко И.В., Соколов А.А., Семенкин А.А., Шапошник И.И., Ахмеджанов Н.М., Барбараш О.Л., Бубнова М.Г., Воевода М.И., Галявич А.С., Ерёгин С.Я., Коновалов Г.А., Корнева В.А., Покровский С.Н., Раскуражев А.А., Скибицкий В.В., Танашян М.М., Чазова И.Е., Филиппов А.Е., Чубыкина У.В., Якушин С.С.

Ezhov M.V., Kukharchuk V.V., Balakhonova T.V., Gurevich V.S., Sergienko I.V., Sokolov A.A., Semenkin A.A., Shaposhnik I.I., Akhmedzhanov N.M., Barbarash O.L., Bubnova M.G., Voevoda M.I., Galyavich A.S., Eregin S.Y., Konovalov G.A., Korneva V.A., Pokrovsky S.N., Raskurazhev A.A., Skibitsky V.V., Tanashyan M.M., Chazova I.E., Filippov A.E., Chubykina U.V., Yakushin S.S.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.heartj.asia/jour/article/view/6515

Сердечно-сосудистые заболевания являются одной из основных причин смертности и инвалидизации среди населения стран-участниц Евразийской Ассоциации кардиологов, что напрямую связано с высокой распространенностью факторов риска атеросклероза, среди которых ведущую роль играют дислипидемии. Предыдущая версия Евразийских рекомендаций по диагностике и коррекции нарушений липидного обмена с целью профилактики и лечения атеросклероза была представлена в 2020 году. За истекшие 5 лет существенно изменились подходы к стратификации риска, диагностике субклинического атеросклероза, коррекции дислипидемии с помощью различных классов гиполипидемических препаратов. Из приницпиальных обновлений следует выделить предложения по определению уровня липидов крови у каждого взрослого человека или по достижении 18 лет, использования шкал SCORE и/или SCORE2 для стратификации сердечно-сосудистого риска, неинвазивных визуализационных методик для оценки субклинического атеросклероза. В разделах, посвященных терапии, представлены фиксированные комбинации гиполипидемических препаратов, инклисиран, бемпедоевая кислота. Расширены раздел, посвященный распространенности, значимости и подходам к коррекции гипертриглицеридемии, а также раздел по экстракорпоральной гемокоррекции. Введена глава, посвященная липопротеиду(а). Представлены разделы, посвященные коррекции дислипидемии при цереброваскулярных болезнях, трансплантации сердца и ВИЧ-инфекции. Данные рекомендации будут полезны врачам всех специальностей для эффективного ведения своих пациентов.

Cardiovascular diseases are one of the main causes of mortality and disability among the population of the member countries of the Eurasian Association of Cardiology, which is directly related to the high prevalence of risk factors for atherosclerosis, among which dyslipidemia plays a leading role. The previous version of the Eurasian Recommendations for the Diagnosis and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis was presented in 2020. Over the past 5 years, approaches to risk stratification, diagnosis of subclinical atherosclerosis, and correction of dyslipidemia using various classes of lipid-lowering drugs have changed significantly. Among the initial updates, proposals should be highlighted for determining the blood lipid level in each adult or upon reaching the age of 18, using the SCORE and/or SCORE2 scales to stratify cardiovascular risk, and non-invasive imaging techniques to assess subclinical atherosclerosis. In the sections devoted to therapy, fixed combinations of lipid-lowering drugs, inclisiran, and bempedoic acid are presented. The section on the prevalence, significance and approaches to correction of hypertriglyceridemia, as well as the section on extracorporeal hemocorrection, has been expanded. A chapter on lipoprotein(a) is introduced. Sections on correction of dyslipidemia in cerebrovascular diseases, heart transplantation and HIV infection are presented. These recommendations will be useful to the phisicians of all specialties for the effective management of their patients.

дислипидемияатеросклерозхолестерин липопротеидов низкой плотноститриглицеридыгиполипидемическая терапия

dyslipidemiaatherosclerosislow-density lipoprotein cholesteroltriglycerideslipid-lowering therapy

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