Maksymets T. Clinical and pathogenetic aspects of statin administration in patients with coronary artery disease and comorbid obesity.

The thesis is focusing on improvement of diagnostics of carbohydrate metabolism impairment in patients with stable coronary artery disease combined with obesity based on assessment of the patients’ metabolic profiles during hypolipidemic therapy containing atorvastatin. It has been established that more evident proatherogenic and proinflammatory properties of biochemical blood spectrum were observed in patients with coronary artery disease and comorbid obesity compared with patients with overweight. Administration of atorvastatin in the dose of 40 mg in complex treatment of patients with coronary artery disease combined with excessive body weight or obesity is associated with fasting hyperglycemia, hyperinsulinemia, and insulin resistance. It was established that administration of atorvastatin for 12 months by patients with coronary artery disease combined with excessive body weight or obesity is accompanied by increased concentration of insulin and omentin-1. Scientific data have been specified with dose-dependent pleiotropic effect of atorvastatin, in particular anti-inflammatory, based on detection of high-sensitivity C-reactive protein level in patients’ blood serum. Determination of sensitivity index to QUICKI insulin has been considered as optimal method for assessment of insulin resistance in normoglycemic patients with coronary artery disease combined with obesity, and НОMA-IR index has been considered as optimal methodfor patients with pre-diabetes.