Document Detail


HMG-CoA reductase inhibition: anti-inflammatory effects beyond lipid lowering?
MedLine Citation:
PMID:  10829251     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atherosclerosis has many features of a chronic inflammatory disease. Atherosclerotic lesions contain inflammatory cells like activated T-lymphocytes and macrophages. Systemic markers of inflammation such as white blood cells, C-reactive protein, serum amyloid A, interleukin 6 and soluble adhesion molecules are predictive of future cardiovascular events, even after adjustment for the contribution of established cardiovascular risk factors. Atherogenic lipoprotein particles, in particular modified low-density lipoproteins (LDL), elicit pro-inflammatory responses of cellular elements of the vessel wall, including endothelial dysfunction and activation of monocyte-derived macrophages. Treatment, with HMG-CoA reductase inhibitors has proven the most successful strategy to reduce the concentration of LDL in the circulatory system. These compounds lower LDL cholesterol by inhibiting the mevalonate pathway in the liver, which in turn depletes the regulatory pool of cholesterol and enhances the activity of LDL receptors. Five prospective clinical trials have convincingly demonstrated that HMG-CoA reductase inhibitors can effectively lower the incidence of cardiovascular events in primary and secondary prevention. Post hoc analyses of these trials suggest that the clinical benefit brought about by HMG-CoA reductase inhibitors may not entirely be due to their effect on the levels of circulating lipoproteins. In-vitro observations of anti-inflammatory actions of HMG-CoA reductase inhibitors on vascular cells have been suggested to explain effects beyond lipid-lowering. It is, however, not clear whether these findings are relevant to the in-vivo situation. Further investigation is now necessary in order to determine the relative significance of cholesterol lowering and of ancillary effects to the overall clinical benefit of statin treatment.
Authors:
W März; H Wieland
Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Herz     Volume:  25     ISSN:  0340-9937     ISO Abbreviation:  Herz     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-06-23     Completed Date:  2000-06-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7801231     Medline TA:  Herz     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  117-25     Citation Subset:  IM    
Affiliation:
Department of Medicine, Albert Ludwigs-University, Freiburg im Breisgau, Germany. maerz@med1.ukl.uni-freiburg.de
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / pharmacology,  therapeutic use*
Anticholesteremic Agents / therapeutic use*
Arteriosclerosis / drug therapy*
C-Reactive Protein / analysis
Cholesterol / blood,  metabolism
Cholesterol, LDL / blood
Clinical Trials as Topic
Coronary Disease / drug therapy*,  prevention & control
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*,  therapeutic use*
Lipoproteins, LDL / blood
Male
Meta-Analysis as Topic
Middle Aged
Prospective Studies
Randomized Controlled Trials as Topic
Risk Factors
Smoking / adverse effects
Social Class
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Anticholesteremic Agents; 0/Cholesterol, LDL; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Lipoproteins, LDL; 57-88-5/Cholesterol; 9007-41-4/C-Reactive Protein

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


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