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(Circulation. 2000;101:207.)
© 2000 American Heart Association, Inc.
Cardiovascular Drugs |
Current Perspectives on Statins
From the Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University, School of Medicine, Nashville, Tenn.
Abstract—Statins (HMG-CoA
reductase inhibitors) are used widely for the treatment of
hypercholesterolemia. They inhibit HMG-CoA
reductase competitively, reduce LDL levels more than other
cholesterol-lowering drugs, and lower
triglyceride levels in
hypertriglyceridemic patients. Statins are
well tolerated and have an excellent safety record. Clinical trials
in patients with and without coronary heart disease and
with and without high cholesterol have demonstrated
consistently that statins reduce the relative risk of major
coronary events by 
30% and produce a greater absolute
benefit in patients with higher baseline risk. Proposed mechanisms
include favorable effects on plasma lipoproteins,
endothelial function, plaque architecture and
stability, thrombosis, and inflammation. Mechanisms independent of LDL
lowering may play an important role in the clinical benefits conferred
by these drugs and may ultimately broaden their indication from
lipid-lowering to antiatherogenic agents.
Key Words: statins • hypercholesterolemia • trials • atherosclerosis • coronary disease
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 A. P. Tambaki, E. Rizos, V. Tsimihodimos, A. D. Tselepis, and M. Elisaf Effects of Antihypertensive and Hypolipidemic Drugs on Plasma and High-Density Lipoprotein-Associated Platelet Activating Factor-Acetylhydrolase Activity Journal of Cardiovascular Pharmacology and Therapeutics, April 1, 2004; 9(2): 91 - 95. [Abstract] [PDF]
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A J. Kahri, M. M Valkonen, M. K. Vuoristo, and P. J Pentikainen Rhabdomyolysis associated with concomitant use of simvastatin and clarithromycin Ann. Pharmacother., April 1, 2004; 38(4): 719 - 719. [Full Text] [PDF]
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K. Kumagai, H. Nakashima, and K. Saku The HMG-CoA reductase inhibitor atorvastatin prevents atrial fibrillation by inhibiting inflammation in a canine sterile pericarditis model Cardiovasc Res, April 1, 2004; 62(1): 105 - 111. [Abstract] [Full Text] [PDF]
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 P. A. Economides, A. Caselli, E. Tiani, L. Khaodhiar, E. S. Horton, and A. Veves The Effects of Atorvastatin on Endothelial Function in Diabetic Patients and Subjects at Risk for Type 2 Diabetes J. Clin. Endocrinol. Metab., February 1, 2004; 89(2): 740 - 747. [Abstract] [Full Text] [PDF]
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B. N. Singh Survival Advantage with Cardiovascular Drugs: Are they Real? Journal of Cardiovascular Pharmacology and Therapeutics, December 1, 2003; 8(4): 249 - 251. [PDF]
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K. Shimizu, M. Aikawa, K. Takayama, P. Libby, and R. N. Mitchell Direct Anti-Inflammatory Mechanisms Contribute to Attenuation of Experimental Allograft Arteriosclerosis by Statins Circulation, October 28, 2003; 108(17): 2113 - 2120. [Abstract] [Full Text] [PDF]
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S. C. Johnston and J. D. Easton Are Patients With Acutely Recovered Cerebral Ischemia More Unstable? Stroke, October 1, 2003; 34(10): 2446 - 2450. [Abstract] [Full Text] [PDF]
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T. Nishimura, L. T. Vaszar, J. L. Faul, G. Zhao, G. J. Berry, L. Shi, D. Qiu, G. Benson, R. G. Pearl, and P. N. Kao Simvastatin Rescues Rats From Fatal Pulmonary Hypertension by Inducing Apoptosis of Neointimal Smooth Muscle Cells Circulation, September 30, 2003; 108(13): 1640 - 1645. [Abstract] [Full Text] [PDF]
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 M. R. Nangle, M. A. Cotter, and N. E. Cameron Effects of Rosuvastatin on Nitric Oxide-Dependent Function in Aorta and Corpus Cavernosum of Diabetic Mice: Relationship to Cholesterol Biosynthesis Pathway Inhibition and Lipid Lowering Diabetes, September 1, 2003; 52(9): 2396 - 2402. [Abstract] [Full Text] [PDF]
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F. Mulhaupt, C. M Matter, B. R Kwak, G. Pelli, N. R Veillard, F. Burger, P. Graber, T. F Luscher, and F. Mach Statins (HMG-CoA reductase inhibitors) reduce CD40 expression in human vascular cells Cardiovasc Res, September 1, 2003; 59(3): 755 - 766. [Abstract] [Full Text] [PDF]
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S van Wissen, T J Smilde, M D Trip, T. de Boo, J J P Kastelein, and A F H Stalenhoef Long term statin treatment reduces lipoprotein(a) concentrations in heterozygous familial hypercholesterolaemia Heart, August 1, 2003; 89(8): 893 - 896. [Abstract] [Full Text] [PDF]
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E. Bruckert, P. Giral, and P. Tellier Perspectives in Cholesterol-Lowering Therapy: The Role of Ezetimibe, a New Selective Inhibitor of Intestinal Cholesterol Absorption Circulation, July 1, 2003; 107(25): 3124 - 3128. [Full Text] [PDF]
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P. E. Szmitko, P. W.M. Fedak, R. D. Weisel, D. J. Stewart, M. J.B. Kutryk, and S. Verma Endothelial Progenitor Cells: New Hope for a Broken Heart Circulation, June 24, 2003; 107(24): 3093 - 3100. [Full Text] [PDF]
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Z. S. Tan, S. Seshadri, A. Beiser, P. W. F. Wilson, D. P. Kiel, M. Tocco, R. B. D'Agostino, and P. A. Wolf Plasma Total Cholesterol Level as a Risk Factor for Alzheimer Disease: The Framingham Study Arch Intern Med, May 12, 2003; 163(9): 1053 - 1057. [Abstract] [Full Text] [PDF]
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T. Waehre, J. K. Damas, L. Gullestad, A. M. Holm, T. R. Pedersen, K. E. Arnesen, H. Torsvik, S. S. Froland, A. G. Semb, and P.a. Aukrust Hydroxymethylglutaryl coenzyme a reductase inhibitors down-regulate chemokines and chemokine receptors in patients with coronary artery disease J. Am. Coll. Cardiol., May 7, 2003; 41(9): 1460 - 1467. [Abstract] [Full Text] [PDF]
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 S. H. Wilson, A. R. Chade, A. Feldstein, T. Sawamura, C. Napoli, A. Lerman, and L. O. Lerman Lipid-lowering-independent effects of simvastatin on the kidney in experimental hypercholesterolaemia Nephrol. Dial. Transplant., April 1, 2003; 18(4): 703 - 709. [Abstract] [Full Text] [PDF]
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J.-C. Corvol, A. Bouzamondo, M. Sirol, J.-S. Hulot, P. Sanchez, and P. Lechat Differential Effects of Lipid-Lowering Therapies on Stroke Prevention: A Meta-analysis of Randomized Trials Arch Intern Med, March 24, 2003; 163(6): 669 - 676. [Abstract] [Full Text] [PDF]
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 O. Aktas, S. Waiczies, A. Smorodchenko, J. Dorr, B. Seeger, T. Prozorovski, S. Sallach, M. Endres, S. Brocke, R. Nitsch, et al. Treatment of Relapsing Paralysis in Experimental Encephalomyelitis by Targeting Th1 Cells through Atorvastatin J. Exp. Med., March 17, 2003; 197(6): 725 - 733. [Abstract] [Full Text] [PDF]
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C. M. Ballantyne, A. Corsini, M. H. Davidson, H. Holdaas, T. A. Jacobson, E. Leitersdorf, W. Marz, J. P. D. Reckless, and E. A. Stein Risk for Myopathy With Statin Therapy in High-Risk Patients Arch Intern Med, March 10, 2003; 163(5): 553 - 564. [Abstract] [Full Text] [PDF]
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 T. Maeda, T. Kawane, and N. Horiuchi Statins Augment Vascular Endothelial Growth Factor Expression in Osteoblastic Cells via Inhibition of Protein Prenylation Endocrinology, February 1, 2003; 144(2): 681 - 692. [Abstract] [Full Text] [PDF]
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K. Gertz, U. Laufs, U. Lindauer, G. Nickenig, M. Bohm, U. Dirnagl, and M. Endres Withdrawal of Statin Treatment Abrogates Stroke Protection in Mice Stroke, February 1, 2003; 34(2): 551 - 557. [Abstract] [Full Text] [PDF]
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 Y. Majlesi, P. Samorapoompichit, A. W. Hauswirth, G.-H. Schernthaner, M. Ghannadan, M. Baghestanian, A. Rezaie-Majd, R. Valenta, W. R. Sperr, H.-J. Buhring, et al. Cerivastatin and atorvastatin inhibit IL-3-dependent differentiation and IgE-mediated histamine release in human basophils and downmodulate expression of the basophil-activation antigen CD203c/E-NPP3 J. Leukoc. Biol., January 1, 2003; 73(1): 107 - 117. [Abstract] [Full Text] [PDF]
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 K. K. W. Chan, A. M. Oza, and L. L. Siu The Statins as Anticancer Agents Clin. Cancer Res., January 1, 2003; 9(1): 10 - 19. [Abstract] [Full Text] [PDF]
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W. Dichtl, J. Dulak, M. Frick, H. F. Alber, S. P. Schwarzacher, M. P.S. Ares, J. Nilsson, O. Pachinger, and F. Weidinger HMG-CoA Reductase Inhibitors Regulate Inflammatory Transcription Factors in Human Endothelial and Vascular Smooth Muscle Cells Arterioscler. Thromb. Vasc. Biol., January 1, 2003; 23(1): 58 - 63. [Abstract] [Full Text] [PDF]
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V. Schachinger and A. M. Zeiher Atherogenesis--recent insights into basic mechanisms and their clinical impact Nephrol. Dial. Transplant., December 1, 2002; 17(12): 2055 - 2064. [Full Text] [PDF]
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R. Breitling and S. K. Krisans A second gene for peroxisomal HMG-CoA reductase? A genomic reassessment J. Lipid Res., December 1, 2002; 43(12): 2031 - 2036. [Abstract] [Full Text] [PDF]
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 T. Nishimura, J. L. Faul, G. J. Berry, L. T. Vaszar, D. Qiu, R. G. Pearl, and P. N. Kao Simvastatin Attenuates Smooth Muscle Neointimal Proliferation and Pulmonary Hypertension in Rats Am. J. Respir. Crit. Care Med., November 15, 2002; 166(10): 1403 - 1408. [Abstract] [Full Text] [PDF]
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 K.-i. Nezasa, K. Higaki, T. Matsumura, K. Inazawa, H. Hasegawa, M. Nakano, and M. Koike Liver-Specific Distribution of Rosuvastatin in Rats: Comparison with Pravastatin and Simvastatin Drug Metab. Dispos., November 1, 2002; 30(11): 1158 - 1163. [Abstract] [Full Text] [PDF]
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