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Review article: Biomedical intelligence

Vol. 142 No. 0506 (2012)

Statins: have we found the Holy Grail?

  • Raban Jeger
  • Thomas Dieterle
DOI
https://doi.org/10.4414/smw.2012.13515
Cite this as:
Swiss Med Wkly. 2012;142:w13515
Published
29.01.2012

Summary

In coronary artery disease, cardiovascular risk factors are the main targets for primary and secondary prevention. Statins prevent cardiovascular events in patients at risk. However, despite the proven efficacy and safety of statins, relevant side effects exist and should be considered when treating patients.

References

  1. Allender S, Scarborough P, Peto V, Rayner M, Leal J, Luengo-Frenandez R, et al. European cardiovascular disease statistics 2008. Brussels, European Heart Network. 2008, 2008.
  2. Endo A. A gift from nature: The birth of the statins. Nat Med. 2008;14:1050–2.
  3. Armitage J. The safety of statins in clinical practice. Lancet. 2007;370:1781–90.
  4. Furberg CD, Pitt B. Withdrawal of cerivastatin from the world market. Curr Control Trials Cardiovasc Med. 2001;2:205–7.
  5. Brown MS, Goldstein JL. Multivalent feedback regulation of hmg coa reductase, a control mechanism coordinating isoprenoid synthesis and cell growth. J Lipid Res. 1980;21:505–17.
  6. Grundy SM: Hmg-coa reductase inhibitors for treatment of hypercholesterolemia. N Engl J Med. 1988;319:24–33.
  7. Egan A, Colman E. Weighing the benefits of high-dose simvastatin against the risk of myopathy. N Engl J Med. 2011;365:285–7.
  8. Arad Y, Ramakrishnan R, Ginsberg HN. Effects of lovastatin therapy on very-low-density lipoprotein triglyceride metabolism in subjects with combined hyperlipidemia: Evidence for reduced assembly and secretion of triglyceride-rich lipoproteins. Metabolism. 1992;41:487–93.
  9. Chapman M. Are the effects of statins on hdl-cholesterol clinically relevant? Eur Heart J. Supplements 2004;6(Suppl. C):C58–C63.
  10. Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, et al. Efficacy and safety of more intensive lowering of ldl cholesterol: A meta-analysis of data from 170000 participants in 26 randomised trials. Lancet. 2010;376:1670–81.
  11. Bonetti PO, Lerman LO, Napoli C, Lerman A. Statin effects beyond lipid lowering – are they clinically relevant? Eur Heart J. 2003;24:225–48.
  12. Goldstein JL, Brown MS. Regulation of the mevalonate pathway. Nature. 1990;343:425–30.
  13. Walter DH. Insights into early and rapid effects of statin therapy after coronary interventions. Curr Pharm Des. 2004;10:369–73.
  14. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al., (ESC) ESoC, (EACPR) EAfCPaR, Nursing CoC, (EASD) EAfSoD, (IDF-Europe) IDFE, (EUSI) ESI, (ISBM) ISoBM, (ESH) ESoH, (ESGP/FM/WONCA) ESoGPFM, (EHN) EHN: European guidelines on cardiovascular disease prevention in clinical practice: Executive summary. Fourth joint task force of the european society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil. 2007;14(Suppl 2):E1–40.
  15. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al., Rehabilitation EAfCP, Committees ECfPGC-a-: Esc/eas guidelines for the management of dyslipidaemias: The task force for the management of dyslipidaemias of the european society of cardiology (esc) and the european atherosclerosis society (eas). Eur Heart J. 2011;32:1769–818.
  16. Vale N, Nordmann AJ, Schwartz GG, de Lemos J, Colivicchi F, den Hartog F, et al. Statins for acute coronary syndrome. Cochrane Database Syst Rev 2011:CD006870.
  17. Steinberg D. Thematic review series: The pathogenesis of atherosclerosis. An interpretive history of the cholesterol controversy, part v: The discovery of the statins and the end of the controversy. J Lipid Res. 2006;47:1339–51.
  18. Ray KK, Cannon CP. Pathological changes in acute coronary syndromes: The role of statin therapy in the modulation of inflammation, endothelial function and coagulation. J Thromb Thrombolysis. 2004;18:89–101.
  19. Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al., group Sp: Estimation of ten-year risk of fatal cardiovascular disease in europe: The score project. Eur Heart J. 2003;24:987–1003.
  20. Thavendiranathan P, Bagai A, Brookhart MA, Choudhry NK. Primary prevention of cardiovascular diseases with statin therapy: A meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166:2307–13.
  21. Mills EJ, Rachlis B, Wu P, Devereaux PJ, Arora P, Perri D. Primary prevention of cardiovascular mortality and events with statin treatments: A network meta-analysis involving more than 65,000 patients. J Am Coll Cardiol. 2008;52:1769–81.
  22. Ray KK, Seshasai SR, Erqou S, Sever P, Jukema JW, Ford I, et al. Statins and all-cause mortality in high-risk primary prevention: A meta-analysis of 11 randomized controlled trials involving 65,229 participants. Arch Intern Med. 2010;170:1024–31.
  23. Tonelli M, Lloyd A, Clement F, Conly J, Husereau D, Hemmelgarn B, et al. Efficacy of statins for primary prevention in people at low cardiovascular risk: A meta-analysis. CMAJ. 2011;183:E1189–1202.
  24. Taylor F, Ward K, Moore TH, Burke M, Davey Smith G, Casas JP, et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev 2011:CD004816.
  25. Barsness GW, Buller C, Ohman EM, Schechter E, Pucillo A, Taylor MA, et al. Reduced thrombus burden with abciximab delivered locally before percutaneous intervention in saphenous vein grafts. Am Heart J. 2000;139:824–9.
  26. Ridker P, Danielson E, Fonseca F, Genest J, Gotto AJ, Kastelein J, et al. Rosuvastatin to prevent vascular events in men and women with elevated c-reactive protein. N Engl J Med. 2008;359:2195–207.
  27. Ridker PM, MacFadyen JG, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, et al.; JUPITER Study Group: Number needed to treat with rosuvastatin to prevent first cardiovascular events and death among men and women with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein: justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin (JUPITER). Circ Cardiovasc Qual Outcomes. 2009;6:616–23.
  28. Armitage J, Bowman L, Wallendszus K, Bulbulia R, Rahimi K, Haynes R, et al., Group SotEoARiCaHSC: Intensive lowering of ldl cholesterol with 80 mg versus 20 mg simvastatin daily in 12,064 survivors of myocardial infarction: A double-blind randomised trial. Lancet. 2010;376:1658–69.
  29. Sattar N, Preiss D, Murray HM, Welsh P, Buckley BM, de Craen AJ, et al. Statins and risk of incident diabetes: A collaborative meta-analysis of randomised statin trials. Lancet. 2010;375:735–42.
  30. Preiss D, Seshasai SR, Welsh P, Murphy SA, Ho JE, Waters DD, et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: A meta-analysis. JAMA. 2011;305:2556–64.
  31. Neaton JD, Blackburn H, Jacobs D, Kuller L, Lee DJ, Sherwin R, et al. Serum cholesterol level and mortality findings for men screened in the multiple risk factor intervention trial. Multiple risk factor intervention trial research group. Arch Intern Med. 1992;152:1490–500.

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