2012,

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16/01/2013

Global Burden of Disease Study

http://www.thelancet.com/themed/global-burden-of-disease

Global and regional mortality from 235 causes of death for 20 age
groups in 1990 and 2010: a systematic analysis for the Global Burden
of Disease Study 2010 235 20
1990 2010
Global mortality, disability, and the contribution of risk factors: Global
Burden of Disease Study , ,

Selected major risk factors and global and regional burden of disease

Lancet Vol 380 December 15/22/29, 2012

1990 25 2010

 [] ,
2001-2011

10/2001-08/2011
(,
.)

n (% ) 300 (0.8%) 105 (0.2%)

,

, %

3832 (61.9%)

22.1

22.1

25.9

35

1.5

27

4.7

15

2.3

77

8.5

Webber BJ et al. JAMA 2012; 308: 2577-2583

 /
-
( 2001-2011 )
N
/

(%, 95%)

389/3506

11.1 (10.1-12.1)

1 [Reference]

1 [Reference]

37/166

22.3 (15.9-28.7)

2.01 (1.49-2.71)

1.47 (1.10-1.96)

18/128

14.1 (8.0-20.2)

1.27 (0.82-1.96)

1.12 (0.73-1.74)

17/39

43.6 (27.3-59.9)

3.93 (2.72-5.68)

1.88 (1.34-2.65)

14/28

50.0 (30.3-69.7)

4.51 (3.08-6.60)

2.09 (1.43-3.06)

2/10

20.0 (0.0-50.2)

1.80 (0.52-6.25)

0.58 (0.17-1.97)

4/8

50.0 (5.3-94.7)

4.51 (2.24-9.07)

3.14 (1.54-6.44)

(%, 95%)

Webber BJ et al. JAMA 2012; 308: 2577-2583

PCSK9
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!
Fazio S.
http://theheart.medscape.org/

athero.ru

 J.C.Cohen .
Sequence Variations in PCSK9,
Low LDL, and Protection Coronary Heart Disease

PCSK9,
.

, PCSK9
.
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PCSK9 ,

Observations in genetically modified mice suggest that inhibition of PCSK9 activity would enhance
the LDL-lowering effects of statins. These findings, together with the results of the current
study, make PCSK9 an attractive new target for LDL-lowering therapy.

Cohen JC et al. N Engl J Med 2006; 354:1264-72.

, PCSK9

(
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PCSK9

http://theheart.medscape.org
athero.ru

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Barter PJ, Rye K-A. Cholesteryl ester transfer protein (CETP) inhibition as a strategy
to reduce cardiovascular risk. J. Lipid Res. jlr.R024075. First Published on May 1, 2012,

dal-OUTCOMES:
() () ()

(/)

(/)

Schwartz GG et al. for the dal-OUTCOMES Investigators. NEJM 2012, published Nov 5, 2012, NEJM.org.
Schwartz GG et al. for the dal-OUTCOMES Investigators. NEJM 2012, published Nov 5, 2012, NEJM.org.

dal-OUTCOMES:
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(%)

Schwartz GG et al. for the dal-OUTCOMES Investigators. NEJM 2012, published Nov 5, 2012, NEJM.org.

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 AIM-HIGH
The HPS2-THRIVE trial. AIM-HIGH,
, ..
(/ vs
, n=25000).
HPS2-THRIVE 2013 .
The HPS2-THRIVE trial. Despite AIM-HIGH, the verdict is not yet in for niacin because there is still a much larger niacin RCT in progress.
HPS2-THRIVE (Treatment of HDL to Reduce the Incidence of Vascular Events) (niacin/laropiprant vs. placebo on a background
of simvastatin ezetimibe, N = 25,000), is anticipated to be completed in 2013.

HPS2-THRIVE 2012
HPS2-THRIVE ,

, ,

( ).
"The preliminary HPS2-THRIVE results show that, when added to an effective statin-based treatment, the combination
of extended release niacin and laropiprant does not produce clinically meaningful reductions in the rate of major vascular events
(such as heart attacks and strokes."

Merck: HPS 2- THRIVE TREDAPTIVE

( /)

HPS2-THRIVE .
25673 (14741 10932 )
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.
http://www.mercknewsroom.com/press-release/. December 20, 2012 8:30 am EST

 (?)
EMA
/ ( 20130
PRAC , - Tredaptive, Pelzont and
Trevaclyn ( /) :
2013 EMA
(PRAC) ,
Tredaptive, Pelzont Trevaclyn, ,
,
, []
.
PRAC considers that benefit-risk balance of Tredaptive, Pelzont and Trevaclyn (nicotinic acid/laropiprant) is negative
Recommendation by PRAC to be considered by CHMP for final opinion.
During its January 2013 meeting, the EMAs Pharmacovigilance Risk Assessment Committee (PRAC) concluded that the
risks are greater than the benefits for Tredaptive, Pelzont and Trevaclyn, identical medicines used to treat adults with
dyslipidaemia , and it recommended that these medicines should be suspended.

http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/referrals/
Tredaptive,_Pelzont_and_Trevaclyn/human_referral_prac_000014.jsp&mid=WC0b01ac05805c516f

 !

( )
Merck Provides Update on Next Steps for TREDAPTIVE
(extended-release niacin/laropiprant)

TREDAPTIVE.

, TREDAPTIVE,
TREDAPTIVE
.
Merck is recommending that physicians stop prescribing TREDAPTIVE. Merck is also recommending that physicians
review treatment plans for patients taking TREDAPTIVE in a timely manner to discontinue TREDAPTIVE
and consider other changes in therapy to achieve their dyslipidemia management goals.

Friday, January 11, 2013 7:39 am EST

http://www.mercknewsroom.com/press-release/research-and-development-news/
merck-provides-update-next-steps-tredaptive-extended-rel

 :

(Plasma HDL cholesterol and risk of myocardial infarction:
a mendelian randomisation study)

( )

(
- )
,

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Thomas DC , V Conti DV. Commentary: The concept of Mendelian Randomization.

Int J Epidemiol 2004;33:21

 :

(Plasma HDL cholesterol and risk of myocardial infarction:
a mendelian randomisation study)
19139 ()
50812 30 .
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25 (SNPs)
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p<510.

Voight BF et al. Lancet 2012; 380: 572-580

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Ser

FHS=Framingham Heart Study. CCHS=Copenhagen City Heart Study.

MDC=Malmo Diet and Cancer Study. ARIC=Atherosclerosis Risk in Communities Study.
(SNP)
(single nucleotide polymorphism)
Voight BF et al. Lancet 2012; 380: 572-580

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Voight BF et al. Lancet 2012; 380: 572-580

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Voight BF et al. Lancet 2012; 380: 572-580

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(a mendelian randomisation study)
,
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,

.
Some genetic mechanisms that raise plasma HDL cholesterol do not seem to lower risk
of myocardial infarction. These data challenge the concept that raising of plasma
HDL cholesterol will uniformly translate into reductions in risk of myocardial infarction.

Voight B.F, Kathiresan S

Lancet 11 August 2012 , 380: 572.


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