Pleiotropic Effects of Statins

Novije kliničke studije sugeriraju da statini pozitivne učinke na smanjenje kardiovaskularnog rizika ne ostvaruju samo sniženjem razine kolesterola već i nizom o kolesterolu neovisnih – pleiotropnih – učinaka. Navedeni učinci obuhvaćaju poboljšanje endotelne funkcije, slabljenje vaskularnog i miokardijalnog remodeliranja, inhibiciju upalnog odgovora i stabiliziranje plaka, mehanizme koji su važni u kroničnom procesu aterogeneze, a osobito su izraženi u nastajanju akutnih kardiovaskularnih incidenata. Ovaj pregled prikazuje statinski pleiotropizam s obzirom na rezultate bazičnih i kliničkih istraživanja, s posebnim naglaskom na značenje pleiotropnih učinaka u bolesnika s akutnim koronarnim sindromom i visokorizičnih bolesnika sa stabilnom koronarnom bolešću srca.Recent clinical studies suggest that the beneficial effects of statins on cardiovascular risk may not only be due to their cholesterol lowering effects, but also to their cholesterol- independent – pleiotropic – effects. These effects include improvement of endothelial function, attenuating vascular and myocardial remodeling, inhibiting vascular inflammatory response, and stabilizing atherosclerotic plaques, mechanisms which are important in chronic process of atherogenesis, and are particularly pronounced in emerging acute cardiovascular events. This review presents statins pleiotropism through results of basic and clinical studies, with special emphasis on the importance of pleiotropic effects in patients with acute coronary syndrome and in high risk patients with stable coronary artery disease