Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Department of Cardiothoracic Anesthesia, Cleveland Clinic, USA.
Curr Pharm Des. 2012;18(38):6284-90. doi: 10.2174/138161212803832335.
3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are primarily used to treat dyslipidemia. Yet, these medications have a number of additional important pleiotropic properties that confer patient benefit in terms of reduced cardiovascular morbidity. Investigators have reported that statins may be underutilized in patients undergoing cardiac surgical procedures. Periprocedural benefits have been reported both in the short-term as well as with long - term post discharge follow-up period for both surgical and percutaneous coronary interventions. Mechanisms for statin's demonstrated benefit include improved endothelial function, antiinflammatory properties and stabilization of atherosclerotic plaque. While there are well-recognized side effects to statin therapy, its beneficial impact on patient cardiovascular outcomes is clear. Further research is necessary to determine specific patients who would best benefit from preoperative statin therapy, the dose and duration of therapy prior to surgical interventions and the influence of administration following surgery.
3-羟基-3-甲基戊二酰辅酶 A(HMG-CoA)还原酶抑制剂主要用于治疗血脂异常。然而,这些药物具有许多其他重要的多效性特性,可降低心血管发病率,从而为患者带来益处。研究人员报告称,他汀类药物在心外科手术患者中的应用可能不足。围手术期的益处不仅在短期,而且在手术和经皮冠状动脉介入治疗后的长期出院后随访期间都有报道。他汀类药物显示出益处的机制包括改善内皮功能、抗炎特性和稳定动脉粥样硬化斑块。虽然他汀类药物治疗有公认的副作用,但它对患者心血管结局的有益影响是明确的。需要进一步研究来确定哪些特定患者将从术前他汀类药物治疗中获益最大,以及在手术干预前的治疗剂量和持续时间以及手术后的给药影响。