The role of statins in the treatment of cerebrovascular insufficiency caused by atherosclerosis

Abstract

Introduction. Chronic cerebrovascular insufficiency is a common condition in the elderly due to the high prevalence of atherosclerosis. In most cases, the carotid artery is affected, which carries most of the blood supply to the brain. Cerebrovascular diseases include all ischemic disorders of the cerebral vessels that are temporarily or permanently affected. They include ischemic stroke, hemorrhagic stroke, carotid stenosis, vertebral stenosis, intracranial stenosis, aneurysm, vascular malformations, etc. Aim of study. To approach the new principles of treatment of patients with cerebrovascular insufficiency caused by atherosclerosis. Methods and materials. A retrospective study was conducted, analyzing the clinical observation sheets of 30 patients diagnosed with cerebrovascular disorders associated with atherosclerosis of the blood vessels. The study included patients admitted in 2021 to the Neurosurgery Department of the PHCS Institute of Neurology and Neurosurgery, Chisinau. Results. A higher prevalence of atherosclerosis was determined among men, aged 57-71 years. Of the total number of patients with atherosclerosis, 77% were retired. Patients with dyslipidemia were subjected to the analysis of lipid parameters - total cholesterol, LDL, HDL and triglycerides. Of the total number of patients, 35% had dyslipidemia, and 24 patients had high total cholesterol. A normal level of LDL was found in 15 (50%) patients, while a modified level of HDL was revealed in 14 (47%) patients, and an unchanged level of triglycerides was recorded in a patient. The treatment of atherosclerosis included groups of lipidlowering drugs (statins), antiplatelets, venotropic and nootropic drugs, medication that improves brain metabolism (citicoline, cocarboxylase), etc., complying with the treatment regimens of the National Clinical Protocol. Patients with symptomatic carotid stenosis were subjected to surgical treatment, such as carotid endarterectomy. Conclusion. Having a good tolerability and safety profile, statins remain the first line of choice in patients with dyslipidemia and even with normolipidemia. Following a well-thought-out management, statins reduce the risk of morbidity and mortality. Their role in primary and secondary prevention of cardiovascular, cerebrovascular and peripheral arterial diseases in high-risk patients is emphasized in all modern treatment guidelines of specialized scientific societies, namely European, American and global ones.