MEDIFILE: Part I: STATIN THERAPY: WHERE ARE WE TO DATE? Only available on the website.

Abstract

Part I: STATIN THERAPY: WHERE ARE WE TO DATE? Only available on the website. In an editorial in the NEJM in January 2005, Ehrenstein et al stated, “If ever there were a perfect marriage of drug with disease it might be between statins and atherosclerosis….Just as married couples often adapt to each other, so it is with statins and atheroma, or to be more precise, an increased understanding of their relationship has revealed an apparent adaptation. In the last 20 years, statins (inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A, HMG-CoA, reductase) have been one of the most studied antiatherosclerotic therapies. As the trials have progressed the actions of the statins have turned out to be far more complex and extensive than originally thought. These potent anti-athrogenic therapeutic agents have been shown to lower arthrogenic low-density lipoprotein (LDL), improve endothelial function, have multiple immunologic actions, reduce inflammation and thrombus formation, and stabilize atherosclerotic plaques. Recently the ASTEROID trial has suggested that high-dose rosuvastatin may actually regress atherosclerotic plaques. Many trials have indicated that statin drugs can reduce the rate of cardiovascular disease (CVD) and death. However there has been much controversy as to what the optimal levels of LDL should be.