Department of Cardiovascular Medicine, University of Oxford, West Wing Level 6, John Radcliffe Hospital, Headley way, Oxford OX3 9DU, UK.
Curr Opin Pharmacol. 2012 Apr;12(2):172-80. doi: 10.1016/j.coph.2012.01.009. Epub 2012 Feb 10.
Saphenous vein grafts used in coronary artery bypass graft surgery suffer from lower patency rates compared to left internal mammary artery. A number of clinical trials and observational studies have demonstrated a significant benefit of statin treatment on vein graft patency. Aside from their well-known lipid-lowering capacities, statins exert pleiotropic effects by direct inhibition of the mevalonate pathway in the wall of these grafts. This leads to reduced geranylgeranylation of small GTPases such as Rho and Rac. Through this LDL-independent mechanism, statins improve endothelial function and reduce vascular inflammation and oxidative stress, inhibiting also smooth muscle cell proliferation and migration. Although the existing evidence supports a beneficial effect of statins on vein grafts biology, more clinical trials focused on the effect of aggressive statin treatment on vein graft patency are required, in order to safely translate this strategy into clinical practice.
与左内乳动脉相比，用于冠状动脉旁路移植术的大隐静脉移植物通畅率较低。许多临床试验和观察性研究表明他汀类药物治疗对静脉移植物通畅率有显著益处。除了众所周知的降低血脂作用外，他汀类药物还通过直接抑制这些移植物壁中的甲羟戊酸途径发挥多效作用。这导致小 GTPases（如 Rho 和 Rac）的 geranylgeranylation 减少。通过这种 LDL 非依赖性机制，他汀类药物可改善内皮功能，减少血管炎症和氧化应激，还可抑制平滑肌细胞增殖和迁移。尽管现有证据支持他汀类药物对静脉移植物生物学的有益作用，但仍需要更多的临床试验来关注强化他汀类药物治疗对静脉移植物通畅率的影响，以便安全地将这种策略转化为临床实践。
