Document Detail

Statins for post resuscitation syndrome.
MedLine Citation:
PMID:  19254829     Owner:  NLM     Status:  MEDLINE    
After sudden cardiac arrest, successful resuscitation and return of spontaneous circulation, a multi-faceted ischaemia/reperfusion related disorder develops. This condition now known as post resuscitation syndrome is characterised by marked increases in the inflammatory response and changes in coagulation profile and vascular reactivity. Additionally, the production of reactive oxygen species and activation of cytotoxic cascades of metabolism add to these injury mechanisms resulting in multiorgan perfusion deficits and dysfunction. Especially in the cerebrum these injuries may be the cause of significant morbidity and mortality. Recent evidence has shown that statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) exert numerous beneficial effects in cardiovascular diseases irrespective of the lipid status. Remarkably, these pleiotropic effects seem to extended beyond cardiovascular diseases such as immunomodulative and antioxidative properties. We hypothesised that administration of statins early in the post resuscitation phase would prove beneficial in the resuscitated patient via several pleiotropic effects. These include inhibition of excessive coagulation and inflammatory response, suppression of oxygen radical production and improved vascular reactivity. The discussed effects are mediated via multiple pathways activated in the cardiac arrest victim, to which statins have been shown to have a beneficial modulating effect in experimental settings and non-cardiac arrest patients. To test this hypothesis in clinical practice, a randomized, controlled trial with sufficient power and standardised post resuscitation treatment would be necessary. The generally good tolerance of statin therapy with minimal adverse effects would support this experiment, although a parenteral form of the drug to ensure adequate dosage might be a prerequisite.
Antti Kämäräinen; Ilkka Virkkunen; Tom Silfvast; Jyrki Tenhunen
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Publication Detail:
Type:  Journal Article     Date:  2009-02-28
Journal Detail:
Title:  Medical hypotheses     Volume:  73     ISSN:  1532-2777     ISO Abbreviation:  Med. Hypotheses     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-04-27     Completed Date:  2009-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505668     Medline TA:  Med Hypotheses     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  97-9     Citation Subset:  IM    
Medical School, University of Tampere, Tampere, Finland.
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MeSH Terms
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
Models, Immunological*
Reactive Oxygen Species / immunology*
Reperfusion Injury / etiology*,  immunology*,  prevention & control
Resuscitation / adverse effects*
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Reactive Oxygen Species

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

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