Erez G, Leitersdorf E
Center for Research, Prevention and Treatment of Atherosclerosis, Department of Medicine B, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Eur J Vasc Endovasc Surg. 2007 Feb;33(2):192-201. doi: 10.1016/j.ejvs.2006.11.020. Epub 2006 Dec 19.
Atherosclerosis is a systemic process, and the leading cause of morbidity and mortality in the developed world. HMG-CoA reductase inhibitors ('statins') are potent lipid lowering drugs, which have been shown to reduce morbidity and mortality in patients with coronary atherosclerosis.
To present the up-to-date data concerning statin use in the prevention and treatment of extra-coronary atherosclerosis.
Clinical trials with statins in patients with extra-coronary atherosclerosis were searched for via PUBMED.
The different forms of peripheral arterial disease (e.g. cerberovascular disease, lower extremity peripheral arterial disease) are associated with significant cardiovascular morbidity and mortality, and hence constitute a coronary artery disease equivalent in terms of published practice guidelines. There is some evidence from small randomized controlled trials that statin therapy decreases cardiovascular morbidity and mortality in patients with peripheral arterial disease. The mechanism of action of statins may derive from their lipid lowering properties, or from other, pleiotropic effects. Further, larger randomized controlled studies with statins are needed to evaluate the efficacy of statin therapy in patients with stable peripheral arterial disease and in those undergoing vascular or endovascular surgery.
动脉粥样硬化是一个全身性过程，是发达国家发病和死亡的主要原因。HMG-CoA还原酶抑制剂（“他汀类药物”）是强效降脂药物，已被证明可降低冠状动脉粥样硬化患者的发病率和死亡率。
提供有关他汀类药物在预防和治疗冠状动脉外动脉粥样硬化方面的最新数据。
通过PUBMED搜索他汀类药物治疗冠状动脉外动脉粥样硬化患者的临床试验。
不同形式的外周动脉疾病（如脑血管疾病、下肢外周动脉疾病）与显著的心血管发病率和死亡率相关，因此根据已发表的实践指南，它们相当于冠状动脉疾病。小型随机对照试验有一些证据表明，他汀类药物治疗可降低外周动脉疾病患者的心血管发病率和死亡率。他汀类药物的作用机制可能源于其降脂特性，或其他多效性作用。此外，需要进行更大规模的他汀类药物随机对照研究，以评估他汀类药物治疗对稳定型外周动脉疾病患者以及接受血管或血管内手术患者的疗效。
