CardioSomaticsCardioSomaticsCardioСоматика2221-71852658-5707Eco-Vector68822410.17816/CS688224COVUTHConsensusКонсенсусыResearch ArticleHypertriglyceridemia (triglyceride-rich lipoproteins and their remnants): role in development of atherosclerotic cardiovascular diseases and control strategy consensus statement of the expert Committee of the Russian Society of Cardiology (RSC), the National Atherosclerosis Society (NAS), and the Russian Society of Cardiovascular Prevention and Rehabilitation (RosOKR)Гипертриглицеридемия (триглицерид-богатые липопротеины и их ремнанты): роль в развитии атеросклеротических сердечно-сосудистых заболеваний и стратегия контроля. Заключение Комитета экспертов Российского кардиологического общества (РКО), Национального общества по изучению атеросклероза (НОА), Российского общества кардиосоматической реабилитации и вторичной профилактики (РосОКР)https://orcid.org/0000-0003-2250-59426733-1430BubnovaMarina G.БубноваМарина Геннадьевна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

mbubnova@gnicpm.ruhttps://orcid.org/0000-0002-1518-65527623-2135EzhovMarat V.ЕжовМарат Владиславович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

MVEzhov@cardio.ruhttps://orcid.org/0000-0003-0484-98055094-6509AronovDavid M.АроновДавид Меерович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

daronov@gnicPM.ruhttps://orcid.org/0000-0002-4510-61974694-0795GalyаvichAlbert S.ГалявичАльберт Сарварович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

agalyavich@mail.ruhttps://orcid.org/0000-0002-6815-444X3267-2301GurevichViktor S.ГуревичВиктор Савельевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

ater@med122.comhttps://orcid.org/0000-0002-6453-29765665-9578DuplyakovDmitry V.ДупляковДмитрий Викторович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

duplyakov@yahoo.comhttps://orcid.org/0000-0003-3883-86969844-3747ZafirakiVitaliy K.ЗафиракиВиталий Константинович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

vzaphir@mail.ruhttps://orcid.org/0000-0002-8604-712X2878-3016KaramnovaNatalia S.КарамноваНаталья Станиславовна
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

nkaramnova@gnicpm.ruhttps://orcid.org/0000-0003-3729-616X8816-7409KashtalapVasily V.КашталапВасилий Васильевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

v_kash@mail.ruhttps://orcid.org/0000-0001-6644-3064KonovalovGennady A.КоноваловГеннадий Александрович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

mbubnova@gnicpm.ruhttps://orcid.org/0000-0001-5989-62336340-5187MeshkovAlexey N.МешковАлексей Николаевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

eleno4ka_g@mail.ruhttps://orcid.org/0000-0001-6115-79234790-3880ObrezanAndrey G.ОбрезанАндрей Григорьевич
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук, профессор

obrezan1@yandex.ruhttps://orcid.org/0000-0002-3786-99955836-8365SemenkinAlexander A.СеменкинАлександр Анатольевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

asemyonkin@mail.ruhttps://orcid.org/0000-0003-1534-39651643-1586SergienkoIgor V.СергиенкоИгорь Владимирович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

igorcardio@mail.ruhttps://orcid.org/0000-0002-4413-50689717-0103FilippovAlexander E.ФилипповАлександр Евгеньевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

AEFilippov@hse.ruNational Medical Research Center for Therapy and Preventive MedicineНациональный медицинский исследовательский центр терапии и профилактической медициныNational Medical Research Center of Cardiology named after Academician E.I. ChazovНациональный медицинский исследовательский центр кардиологии им. акад. Е.И. ЧазоваKazan State Medical UniversityКазанский государственный медицинский университетSaint Petersburg State UniversityСанкт-Петербургский государственный университетMechnikov Northwestern State Medical UniversityСеверо-Западный государственный медицинский университет им. И.И. МечниковаSamara State Medical UniversityСамарский государственный медицинский университетKuban State Medical UniversityКубанский государственный медицинский университетKemerovo State Medical UniversityКемеровский государственный медицинский университетClinical and Diagnostic Center MEDSI BelorusskayaКлинико-диагностический центр «МЕДСИ на Белорусской»Omsk State Medical UniversityОмский государственный медицинский университет03102025091220251631922182407202524072025Copyright ©; 2025, Eco-VectorCopyright ©; 2025, ООО "Эко-Вектор"2025Eco-VectorООО "Эко-Вектор"https://creativecommons.org/licenses/by-nc-nd/4.0https://cardiosomatics.ru/2221-7185/article/view/688224

This expert consensus document discusses the high prevalence of cardiovascular diseases (CVDs) caused by atherosclerosis. It is now evident that the causes and pathogenesis of atherosclerotic cardiovascular diseases (ASCVD) cannot always be explained solely by lipid metabolism disorders associated with low-density lipoproteins (LDL). In recent years, an increasing number of studies have focused on hypertriglyceridemia (HTG), including its mechanisms and role in atherothrombogenesis. In this regard, it has become necessary to update key aspects that define the root causes of ASCVD in HTG and the role of triglyceride-rich lipoproteins (TRLs) and their remnants in this process. Epidemiologic and genetic studies have demonstrated a causal relationship between HTG and the development of ASCVD, independent of LDL-C levels. The role of TRLs in determining high residual cardiovascular risk under conditions of LDL-C control has been established, and evidence has been obtained supporting the preventive benefits of lowering elevated plasma triglyceride levels. This document presents the consensus positions of experts regarding the classification, etiology, and mechanisms of HTG, the importance of assessing TRLs/remnants, and a detailed discussion of their metabolism and pathophysiologic role in atherothrombosis. The experts also address the clinical assessment and patient management pathways for HTG, outlining both nonpharmacologic and pharmacologic strategies for its correction.

В представленном экспертном документе обсуждается проблема высокой распространённости сердечно-сосудистых заболеваний (ССЗ), обусловленных атеросклерозом. Сегодня очевидно, что причины и генез атеросклеротических ССЗ (АССЗ) не всегда можно объяснить с позиции нарушения липидного обмена, основанного исключительно на липопротеинах низкой плотности (ЛНП). В последние годы наблюдается рост количества исследований, посвящённых гипертриглицеридемии (ГТГ), обсуждаются механизмы ее формирования и значимость в атеротромбогенезе. В этой связи возникает необходимость актуализации ключевых вопросов, определяющих первопричину развития АССЗ при ГТГ и роль компонентов триглицерид-богатых липопротеинов (ТГ-богатых ЛП) и их ремнантов в этом процессе. К настоящему времени завершены эпидемиологические и генетические исследования, свидетельствующие о причинно-следственной связи ГТГ с развитием АССЗ независимо от уровня холестерина (ХС) ЛНП; определена значимость ТГ-богатых ЛП в формировании высокого остаточного сердечно-сосудистого риска на фоне контроля уровня ХС ЛНП; получены доказательства профилактической пользы при снижении повышенного уровня ТГ в крови.

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