COLLABORATION BETWEEN PHYSICIAN AND CLINICAL PHARMACIST IN THE TREATMENT OF CARDIOVASCULAR DISEASES WITH STATINS

Abstract

Coronary artery disease is the most common cause of death worldwide. [1] According to statistics, about 17.9 million people died from this disease in 2019, which is 32% of the total deaths. [2] The incidence of coronary heart disease correlates with high levels of low-density lipoprotein (LDL-C, the "bad" cholesterol) and triglycerides, and with low levels of high-density lipoprotein cholesterol (HDL-C; the "good" cholesterol).

Hyperlipidemia may develop from a genetic defect in lipoprotein metabolism, or more often from lifestyle and genetic factors. [1,3] It should be noted that the disturbance of lipoprotein metabolism is an important risk factor for the development of atherosclerotic cardiovascular disease. [5,6,7] One of the stages of prevention measures includes lipid-lowering therapy, blood pressure control and proper nutrition. [2].

However, diet, exercise, weight loss, in many cases are not enough to normalize the level of lipoproteins, in such cases medical treatment is necessary in the treatment of dyslipidemia with drugs of first choice - (HMG CoA) reductase inhibitors. with statins. [1]

Statins reduce cholesterol synthesis in the liver by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase and cause a decrease in plasma cholesterol concentration. Pivastatin, rosuvastatin, and atorvastatin are the most effective in lowering low-density lipoproteins among statins, while simvastatin, pravastatin, and lovastatin are less effective. [1,3]

(Relevance) During the treatment of atherosclerotic cardiovascular diseases, there is a high risk of polypharmacy due to the prescription of a large number of drugs. At the same time, it is necessary to take into account the patient's chronic diseases.