Laboratory of Lipid Disorders

Main directions of scientific research

The laboratory of lipid disorders was created in February 2019 based on the department of atherosclerosis.

The specificity of the laboratory is the combination of clinical activity with laboratory verification of genetic, biochemical and immunological factors that initiate the development of atherosclerosis.

A laboratory employees work in a close relationship with the laboratory of atherosclerosis (head, Professor S.N. Pokrovsky). This collaboration gives the possibility to study atherosclerosis from the various aspects of pathophysiology and to identify new markers of the atherosclerotic process in patients of different age and clinical groups.

The laboratory employees regularly participate in international conferences, undergo advanced training in schools supported by the European Society of Cardiology and the European Society of Atherosclerosis. Since the creation of the laboratory, more than 25 articles have been published, including in journals with an impact factor of more than 11, research results are presented at annual cardiology congresses. Under the guidance of the head of laboratory M.V. Ezhov Russian guidelines for the diagnosis and treatment of familial hypercholesterolemia were issued.

On the basis of the laboratory, a lipid center was created for consulting and management of patients with various forms of lipid disorders.

Patients are consulted with:

1. Premature development of cardiovascular disease (male < 55 years old, female < 60 years old)
2. Hypercholesterolemia in patients or their relatives (total cholesterol level without lipid-lowering therapy> 7.5 mmol/l, low-density lipoprotein cholesterol> 4.9 mmol/l).
3. Phenotypic signs (arcus lipoides corneae, xanthelasmas or tendon xanthomas).
4. Hypertriglyceridemia (triglycerides ≥ 4.5 mmol/l).
5. Elevated lipoprotein(a) level (≥30 mg/dl).
6. Failure to achieve target levels of low-density lipoprotein cholesterol on maximal lipid-lowering therapy (high risk ̶ low-density lipoprotein cholesterol ≤ 1.8 mmol/l; very high risk ̶ low-density lipoprotein cholesterol ≤ 1.4 mmol/l).
7. Intolerance to statins and lipid-lowering therapy.
8. For referral to receive drugs from the group of proprotein convertase subtilisin/kexin type 9 inhibitors (iPCSK9) under general health insurance.
9. Atherosclerosis of peripheral arteries and failure to achieve low-density lipoprotein cholesterol target levels.

The laboratory employees maintain the RENAISSANCE registry (Registry of patients with FH and very high cardiovascular risk with insufficient effect of hypolipidemic therapy), the purpose of which is to increase the efficiency of treatment of patients with cardiovascular diseases, the introduction of screening programs of lipid disorders for the identification the same patients and in order to reduce cardiovascular morbidity and mortality.

Key research findings:

1. The adherence to hypolipidemic therapy of patients with familial is low.
2. The frequency of hyperlipoproteinemia(a) and its relationship with the severity of atherosclerotic lesions of the coronary and peripheral arteries were determined.
3. In patients with familial hypercholesterolemia the frequency of hyperlipoproteinemia(a) and its relationship with the probability of having multivessel coronary artery disease and stenosing carotid arteries atherosclerosis was established.
4. In the framework of prospective observation of patients with familial hypercholesterolemia, the relationship of lipoprotein(a) and carotid artery stenosis with an increased risk of cardiovascular complications was proved.
5. Evaluation of the relationship of autoantibodies Ig M against lipoprotein(a) with atherosclerosis of the arteries of the lower extremities and/or carotid arteries.
6. A threshold level of lipoprotein(a) associated with an increased risk of cardiovascular complications in patients with premature atherosclerosis was determined.
7. The effectiveness of lipid disorders cascade and targeted screening in the Russian Federation was determined.
8. The effect of lipoprotein(a) concentration on low-density lipoprotein cholesterol and the clinical diagnosis of familial hypercholesterolemia according to the criteria of Dutch lipid clinics was demonstrated.
9. The frequency of familial hypercholesterolemia and hyperlipoproteinemia(a) in patients with the development of acute coronary syndrome before 60 years was determined.