Via practica 1/2007

STATINS – DO THEY HAVE DOMINANT POSITION IN CARDIOVASCULAR PREVENTION? LIPID LOWERING AND PLEIOTROPIC EFFECTS OF STATINS

In the last decades, substantial progress has been made in understanding the relationship between lipid disorders and the prevention of cardiac ischemic disease. The identification of new therapeutic targets and new lipid modifying agents expands treatment options. Statins have been established as the principal and most effective class of drugs to reduce serum cholesterol levels and cardiovascular events in patients with or without coronary artery disease. Since the discovery of the first statin, 30 years ago, this class of drugs has advanced to become the mainstay of cholesterol-lowering therapy. it was found during the last years that many of statin positive effects cannot be explained simply only by lowering of atherogenic lipids. There were shown also non-lipid modifiable effects of statins called pleiotropic ones, which should be responsible for this additional benefit. The most important positive pleiotropic effects of statins are antiinflammatory, antiproliferative, antithrombotic ones, improvement of endothelial dysfunction.

Keywords: statins, cardiovascular prevention, pleiotropic effects, atherosclerosis.