Cardioprotective and other emerging effects of statins.

The lipid-lowering properties of statins are accompanied by a number of other cardioprotective effects. These 'pleiotropic' actions affect almost the entire process of atherogenesis, from initial endothelial injury to the moment of plaque rupture and thrombosis. This paper discusses the nonlipid-lowering effects of statins that affect the initiation, progression, regression and repair of atherosclerosis lesions, as well as factors that affect plaque instability. The emergent anti-inflammatory, antioxidant and immunomodulatory properties of statins are extensive and diverse. Many of these properties, which are independent of cholesterol synthesis inhibition, help to reduce the ischaemic burden on the cardiovascular system. In addition, the immunomodulatory properties of statins may provide new indications for these agents in the treatment of autoimmune diseases.