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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">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.33667/10.33667/2078-5631-2023-13-11-17</article-id><article-id custom-type="elpub" pub-id-type="custom">medalphabet-3234</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>Статьи</subject></subj-group></article-categories><title-group><article-title>Современная стратегия комбинированной антигиперлипидемической терапии в постинфарктном периоде: фокус на фитостероидных сапонинах</article-title><trans-title-group xml:lang="en"><trans-title>Modern strategy of combined antihyperlipidemic therapy in the post-infarction period: focus on phytosteroid saponins</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8515-7485</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Богданов</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Bogdanov</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Богданов Альфред Равилевич, д.м.н., проф. кафедры факультетской терапии; советник ректора; зав. отделением кардиологии для больных с острым инфарктом миокарда</p><p>Москва</p></bio><bio xml:lang="en"><p>Bogdanov Alfred R., Grand PhD in Medical sciences, Professor of the Department of Faculty Therapy; advisor to the rector; Head of the Department of Cardiology for Patients with Acute Myocardial Infarction</p><p>Moscow</p></bio><email xlink:type="simple">bogdanov.ar@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-7209-2859</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кумбатова</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kumbatova</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кумбатова Анастасия Владимировна, врач-кардиолог отделения кардиологии для больных с острым инфарктом миокарда</p><p>Москва</p></bio><bio xml:lang="en"><p>Kumbatova Anastasiya V., cardiologist of the Cardiology Department for patients with acute myocardial infarction</p><p>Moscow</p></bio><email xlink:type="simple">anas-korotneva90@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4040-2971</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Федулаев</surname><given-names>Ю. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Fedulaev</surname><given-names>Yu. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Федулаев Юрий Николаевич, д.м.н., зав. кафедрой факультетской терапии</p><p>Москва</p></bio><bio xml:lang="en"><p>Fedulaev Yuriy N., Grand PhD in Medical sciences, Professor, Head of the Department of Faculty Therapy</p><p>Moscow</p></bio><email xlink:type="simple">kuwert@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России; ФГБОУ ВО «Российский государственный социальный университет»; ГБУЗ «Городская клиническая больница № 13 Департамента здравоохранения г. Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian National Research Medical University named after N.I. Pirogov;  Russian State Social University; City Clinical Hospital N13 of the Moscow City Health Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ГБУЗ «Городская клиническая больница № 13 Департамента здравоохранения г. Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>City Clinical Hospital N13 of the Moscow City Health Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian National Research Medical University named after N.I. Pirogov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>18</day><month>10</month><year>2023</year></pub-date><volume>0</volume><issue>13</issue><issue-title>Современная поликлиника (1)</issue-title><fpage>11</fpage><lpage>17</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Богданов А.Р., Кумбатова А.В., Федулаев Ю.Н., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Богданов А.Р., Кумбатова А.В., Федулаев Ю.Н.</copyright-holder><copyright-holder xml:lang="en">Bogdanov A.R., Kumbatova A.V., Fedulaev Y.N.</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.med-alphabet.com/jour/article/view/3234">https://www.med-alphabet.com/jour/article/view/3234</self-uri><abstract><p>Пациенты, перенесшие инфаркт миокарда, имеют высокий риск повторных сердечно-сосудистых событий – почти у каждого пятого больного в течение первого года развиваются новые эпизоды острой ишемии миокарда [<xref ref-type="bibr" rid="cit5">5</xref>]. Одной из важнейших задач терапии этих больных является максимально эффективное и раннее снижение атерогенных фракций липопротеидов до целевых значений. Инициирующей базовой терапией выступают статины, доказавшие свою высокую эффективность. Однако у ряда больных необходимое высокодозовое лечение статинами реализовать невозможно ввиду развивающихся побочных действий или непереносимости. В статье рассматриваются вопросы комбинированной антигиперлипидемической терапии с обсуждением роли всех имеющихся групп лекарственных препаратов. Рассматривается возможная клинико-фармакологическая ниша фитостероидных сапонинов.</p></abstract><trans-abstract xml:lang="en"><p>Patients who have suffered a myocardial infarction have a high risk of recurrent cardiovascular events – almost every fifth patient develops new episodes of acute myocardial ischemia during the first year [<xref ref-type="bibr" rid="cit5">5</xref>]. One of the most important tasks of the therapy of these patients is the most effective and early reduction of atherogenic lipoprotein fractions to target values. The initiating basic therapy is statins, which have proven to be highly effective. However, in a number of patients, the necessary high-dose statin treatment cannot be implemented due to developing side effects or intolerance. The article discusses the issues of combined antihyperlipidemic therapy with a discussion of the role of all available groups of drugs. A possible clinical and pharmacological niche of phyto-steroid saponins is being considered.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>острый коронарный синдром</kwd><kwd>инфаркт миокарда</kwd><kwd>вторичная профилактика</kwd><kwd>статины</kwd><kwd>растительные сапонины</kwd><kwd>вазоспонин</kwd><kwd>атеросклероз</kwd><kwd>липопротеиды</kwd><kwd>дислипидемия</kwd><kwd>PCSK9</kwd></kwd-group><kwd-group xml:lang="en"><kwd>acute coronary syndrome</kwd><kwd>myocardial infarction</kwd><kwd>secondary prevention</kwd><kwd>statins</kwd><kwd>plant saponins</kwd><kwd>vasosponin</kwd><kwd>atherosclerosis</kwd><kwd>lipoproteins</kwd><kwd>dyslipidemia</kwd><kwd>PCSK9</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Концевая А. В., Баланова Ю. А., Имаева А. Э., Деев А. Д., Капустина А. В., Муромцева Г.А., Евстифеева С.Е., Шальнова С.А. от имени участников исследования ЭССЕ-РФ. 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