Stalenhoef Anton F H
Department of Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
J Vasc Surg. 2009 Jan;49(1):260-5. doi: 10.1016/j.jvs.2008.11.070.
There is overwhelming evidence that statins reduce morbidity and mortality in patients with coronary disease. Statins have also been shown to reduce the risk of (recurrent) stroke. Low-density lipoprotein (LDL)-cholesterol, which plays a causal role in the development of atherosclerotic disease, is the primary lipid target in prevention, and is effectively reduced by these agents. In this review, studies are summarized addressing the issues whether statins also directly influence the atherosclerotic process in peripheral arterial disease, carotid artery stenosis, and growth of abdominal aortic aneurysms, and whether statins have an effect on perioperative outcomes in vascular surgery patients. It appears that the evidence of statins on peripheral arterial disease is scarce and its effect on perioperative outcome inconclusive. Prospective randomized trials to answer these questions cannot be performed anymore, however, because all vascular patients should receive statin treatment as secondary prevention of cardiovascular disease.
有压倒性的证据表明，他汀类药物可降低冠心病患者的发病率和死亡率。他汀类药物也已被证明可降低（复发性）中风的风险。低密度脂蛋白（LDL）胆固醇在动脉粥样硬化疾病的发展中起因果作用，是预防中的主要脂质靶点，并且这些药物可有效降低其水平。在本综述中，总结了一些研究，这些研究探讨了他汀类药物是否也直接影响外周动脉疾病、颈动脉狭窄和腹主动脉瘤生长中的动脉粥样硬化过程，以及他汀类药物对血管手术患者围手术期结局是否有影响。似乎他汀类药物对外周动脉疾病的证据很少，其对围手术期结局的影响尚无定论。然而，由于所有血管疾病患者都应接受他汀类药物治疗作为心血管疾病的二级预防，因此无法再进行前瞻性随机试验来回答这些问题。
