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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ssmu</journal-id><journal-title-group><journal-title xml:lang="ru">Бюллетень сибирской медицины</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of Siberian Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-0363</issn><issn pub-type="epub">1819-3684</issn><publisher><publisher-name>Siberian State Medical University, the Ministry of Healthcare of the Russian Federation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.20538/1682-0363-2021-1-200-212</article-id><article-id custom-type="elpub" pub-id-type="custom">ssmu-4294</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ И ЛЕКЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW AND LECTURES</subject></subj-group></article-categories><title-group><article-title>Технология коронарного стентирования и роль воспаления в атерогенезе: проблемы и перспективы</article-title><trans-title-group xml:lang="en"><trans-title>Coronary stent technology and the role of inflammation in the atherogenesis: problems and prospects</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4358-7329</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рябов</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Ryabov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> д-р мед. наук, доцент, руководитель отделения неотложной кардиологии; вед. науч. сотрудник, лаборатория  трансляционной клеточной и молекулярной биомедицины</p><p>Россия, 634012, г. Томск, ул. Киевская, 111А</p><p>Россия, 634050, г. Томск, ул. Ленина, 36</p></bio><bio xml:lang="en"><p>111A, Kievskaya Str., Tomsk, 634012, Russian Federation</p><p>36, Lenina Av., Tomsk, 634050, Russian Federation </p></bio><email xlink:type="simple">rvvt@cardio-tomsk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7109-9074</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кретов</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kretov</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p> канд. мед. наук, вед. науч. сотрудник, врач по рентгенэндоваскулярной диагностике и лечению</p><p>Россия, 630055, г. Новосибирск, ул. Речкуновская, 15</p></bio><bio xml:lang="en"><p>15, Reckunovskaya Str., Novosibirsk, 630055, Russian Federation </p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9050-4493</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попов</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Popov</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p> д-р мед. наук, профессор, академик РАН, руководитель отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции, директор; зам. директора по научной и лечебной работе </p><p>Россия, 634012, г. Томск, ул. Киевская, 111А</p></bio><bio xml:lang="en"><p> 111A, Kievskaya Str., Tomsk, 634012, Russian Federation </p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0124-976X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хасанов</surname><given-names>И. Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Khassanov</surname><given-names>I. Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p> канд. физ.-мат. наук, науч. сотрудник, кафедра биомедицинской техники Фонда Макса Шальдаха</p><p>Германия, 91052, г. Эрланген, Henkestraße, 91</p><p>Германия, 12359, г. Берлин, Woermannkehre, 1</p></bio><bio xml:lang="en"><p>91, Henkestraße, Erlangen, 91052, Germany</p><p>1, Woermannkehre, Berlin, 12359, Germany</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7166-9372</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яковлев</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakovlev</surname><given-names>M. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p> д-р мед. наук, профессор, академик РАЕН, зав. лабораторией системной эндтоксинемии и шока, директор</p><p>Россия, 125315, г. Москва, ул. Балтийская, 8</p><p>Россия, 127083, г. Москва, ул. Нижняя Масловка, 19</p><p>Россия, 117997, г. Москва, ул. Островитянина, 1</p></bio><bio xml:lang="en"><p>8, Baltiyskaya Str., Moscow, 125315, Russian Federation</p><p>19, Nizhnyaja Maslovka Str., Moscow, 127083б Russian Federation</p><p>1, Ostoviyuanova Str., Moscow, 117997, Russian Federation</p></bio><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинский центр (НИМЦ) Российской академии наук;&#13;
Национальный исследовательский Томский  государственный университет (НИ ТГУ)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC), Russian Academy of Sciences;&#13;
 National Research Tomsk State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр им. акад. Е.Н. Мешалкина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Meshalkin National Medical Research Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Научно-исследовательский институт (НИИ) кардиологии, Томский национальный исследовательский медицинский центр (НИМЦ) Российской академии наук</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC), Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Университет Эрланген-Нюрнберг им. Фридриха-Александра;&#13;
БИОТРОНИК</institution><country>Германия</country></aff><aff xml:lang="en"><institution>Friedrich Alexander University Erlangen-Nuremberg;&#13;
BIOTRONIK</institution><country>Germany</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Научно-исследовательский институт (НИИ) общей патологии и патофизиологии Российской академии наук;&#13;
ООО «Клинико-диагностическое общество»;&#13;
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of General Pathology and Pathophysiology;&#13;
Clinical and Diagnostic Company LLC;&#13;
Pirogov Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2021</year></pub-date><pub-date pub-type="epub"><day>11</day><month>04</month><year>2021</year></pub-date><volume>20</volume><issue>1</issue><fpage>200</fpage><lpage>212</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Рябов В.В., Кретов Е.И., Попов С.В., Хасанов И.Ш., Яковлев М.Ю., 2021</copyright-statement><copyright-year>2021</copyright-year><copyright-holder xml:lang="ru">Рябов В.В., Кретов Е.И., Попов С.В., Хасанов И.Ш., Яковлев М.Ю.</copyright-holder><copyright-holder xml:lang="en">Ryabov V.V., Kretov E.I., Popov S.V., Khassanov I.S., Yakovlev M.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://bulletin.ssmu.ru/jour/article/view/4294">https://bulletin.ssmu.ru/jour/article/view/4294</self-uri><abstract><p> Ишемическая болезнь сердца (ИБС) остается одной из ведущих причин смертности в развитых индустриальных странах. Своевременная эффективная помощь данному контингенту больных зависит от доступности и эффективности применения эндоваскулярных методов лечения ИБС. Чрескожное коронарное вмешательство (ЧКВ) с применением стентов с лекарственным покрытием позволяет добиваться хороших клинических результатов даже у самых тяжелых групп пациентов. Остаются  актуальными вопросы персонализации планового  инвазивного лечения пациентов с хроническим  коронарным синдромом, а также оптимальной вторичной профилактики повторных клинических событий у пациентов, благополучно переживших острый коронарный синдром и ЧКВ.Одной из важнейших и неразрешенных проблем в  патофизиологии ИБС является оценка характера  воспалительной реакции, развивающейся в венечных  сосудах и миокарде в ответ на ишемическое повреждение и ЧКВ. Представляют интерес клинические исследования, направленные на изучение корреляции показателей провоспалительного статуса пациентов с частотой развития  повторных неблагоприятных клинических событий с целью выявления индуктора системного и местного (в стенте)  воспаления. Вероятным кандидатом является кишечный  эндотоксин, способный индуцировать системное  воспаление и таким образом играющий существенную роль в атерогенезе. Необходимы исследования взаимодействия  параметров эндотоксиновой и цитокиновой систем для  выработки терапевтической концепции поддержки больных  ИБС, в том числе после проведения процедуры стентирования коронарных артерий. Использование  показателей системной эндотоксинемии в прогнозе течения заболевания может быть дополнительным фактором для выработки подходов, основанных на биомаркерах для  идентификации больных с активным воспалением  или  фиброзом, что привело бы к разработке специфической  терапии, направленной на подавление провоспалительных  медиаторов и защиту сердца от воспалительного  повреждения. </p></abstract><trans-abstract xml:lang="en"><p> Coronary artery disease (CAD) remains one of the leading causes of death in developed industrial countries. Timely and effective medical care for CAD patients depends on availability and application of endovascular methods for CAD treatment. Percutaneous coronary intervention (PCI) using drug- eluting stents allows to achieve good clinical results even in most severe patients. The issues of personalized invasive treatment for patients with chronic coronary syndrome and optimal prevention of recurrent clinical events in survivors of acute coronary syndrome and PCI remain relevant.One of most important and unresolved problems in the pathophysiology of CAD is assessment of the nature of the inflammatory reaction that develops in the coronary vessels and myocardium in response to ischemic damage and PCI. Clinical studies focused on exploring correlation between the pro-inflammatory parameters of the patient’s status and the rate of secondary adverse events and aimed at revealing triggers of systemic and local inflammation are of great interest. Such a trigger could be the intestinal endotoxin (ET) which is capable of inducing systemic inflammation and, therefore, plays a significant role in the atherogenesis. A relationship between the endotoxin and cytokine system parameters should be investigated to develop a therapeutic concept for supporting CAD patients, including individuals after PCI. Parameters of systemic endotoxemia could be used as additional factors  in developing the biomarker-based approach to identify patients with active inflammation or fibrosis. This could result in development of specific therapy aimed at suppressing pro-inflammatory mediators and protecting the heart from inflammation. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>ишемическая болезнь сердца</kwd><kwd>чрескожное коронарное вмешательство</kwd><kwd>воспаление</kwd><kwd>эндотоксин</kwd><kwd>цитокины</kwd><kwd>системная эндотоксинемия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>coronary artery disease</kwd><kwd>percutaneous coronary intervention</kwd><kwd>inflammation</kwd><kwd>endotoxin</kwd><kwd>cytokines</kwd><kwd>systemic endotoxinemia</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Timmis A., Townsend N., Gale C.P., Torbica A., Lettino M., Petersen S.E., Mossialos E.A., Maggioni A.P., Kazakiewicz D., May H.T., Smedt D.D., Flater M., Zuhlke L., Beltrame J.F., Huculeci R., Tavazzi L., Hindricks G., Bax J., Casadei B., Achenbach S., Wright L., Vardas P. 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