Document Detail


Do structural differences in statins correlate with clinical efficacy?
MedLine Citation:
PMID:  20581679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Statins, by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase, decrease the synthesis not only of cholesterol but also of nonsteroidal mevalonate derivatives. While the first effect translates into plasma cholesterol reductions, the second is related to nonlipid-lowering (pleiotropic) properties. Purpose of this review is to assess the correlation between differences in statin structures and clinical effects. While the cardiovascular benefits of statin chronic therapy are achieved by lowering low-density lipoprotein cholesterol (LDL-C) and should be considered a class effect, the acute ones may reflect structure differences and pleiotropic properties of these drugs. RECENT FINDINGS: Clinical studies conducted in acute coronary syndrome patients suggest that some benefits achieved by early statin treatment could be related to their pleiotropic properties. Indeed, ex-vivo studies showed the ability of sera from hypercholesterolemic patients treated with a single dose of atorvastatin (but not of simvastatin), to inhibit smooth muscle cell proliferation, independently of LDL-C lowering. SUMMARY: These findings give a clinical ground to statins' potentially structure-related anti-inflammatory and pleiotropic properties, opening the possibility to control different aspects of atherosclerosis, by choosing the appropriate statin (tailored therapy), particularly in high-cardiovascular-risk patients.
Authors:
Lorenzo Arnaboldi; Alberto Corsini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in lipidology     Volume:  21     ISSN:  1473-6535     ISO Abbreviation:  Curr. Opin. Lipidol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-13     Completed Date:  2010-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010000     Medline TA:  Curr Opin Lipidol     Country:  England    
Other Details:
Languages:  eng     Pagination:  298-304     Citation Subset:  IM    
Affiliation:
Department of Pharmacological Sciences, Faculty of Pharmacy, Università degli Studi di Milano, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / drug therapy*
Animals
Cardiovascular System / drug effects*,  metabolism
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / chemistry*,  pharmacology,  therapeutic use*
Structure-Activity Relationship
Time Factors
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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