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ISSN 2073-8137
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The lipid-lowering treatment after acute coronary syndrome in the real clinical practice: possible role of the pharmacogenetic interactions

[Original research]
Victoria Brazhnik; Larisa Minushkina; Anastasia Alexandrovna Rogozhina; Anastasia Averkova; Ekaterina Zubova; Olga Koroleva; Marina Chichkova; Niyaz Hasanov; Elena Kosmacheva; Olga Boeva;

The study aimed to assess the possibility of individualizing lipid-lowering therapy in patients after acute coronary syndrome (ACS). The study included 1408 patients from the ORACUL II study, who has undergone ACS for the first time (60.5 % of men, average age 65.18±12.81 years), discharged from the hospital. Statins were prescribed to 1315 (93.4 %) patients at discharge from the hospital. During the first year of observation 778 (55.2 %) patients use statins regularly, 394 (27.9 %) had low adherence to treatment, 236 (16.7 %) refused statins in a month after discharge. Among patients highly adhere to statin treatment, compared with patients without statins or having poor adherence to lipid-lowering therapy, the lower frequency of coronary events (8.1 % and 19.0 % of patients, respectively, p<0.001) was noted and a lower average expected time before coronary outcome (805.9±9.92 vs. 751.3±10.61 days, p=0.002). A significant decrease of statins effect on cardiovascular risk was observed in carriers of A allele of ANXA2 gene, which initially had a higher level of low-density lipoprotein cholesterol than patients without A allele in the genotype (4.18±2.602 mmol/L vs. 3.12±1.197 mmol/L, p=0.017).

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Keywords: acute coronary syndrome, statins, adherence, gene ANXA2


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Pyatigorsk State Research Institute of Balneotherapeutics
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