Wallace Alex, Albadawi Hassan, Hoang Peter, Fleck Andrew, Naidu Sailendra, Knuttinen Grace, Oklu Rahmi
Department of Radiology, Mayo Clinic, Phoenix, AZ, USA.
Division of Vascular & Interventional Radiology, Mayo Clinic, Phoenix, AZ, USA.
Cardiovasc Diagn Ther. 2017 Dec;7(Suppl 3):S207-S218. doi: 10.21037/cdt.2017.09.12.
The anti-inflammatory effects of statins have likely not been used to their fullest extent, particularly in reducing venous thromboembolic events. Current therapy for thrombotic events hinges on anticoagulation via heparin, warfarin or new oral anticoagulants. Interventional procedures with thrombectomy may also play a critical role. Unfortunately, thrombotic events can occur and recur despite meticulous anticoagulation therapy. Venous thromboembolism (VTE) includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), two complicated and prevalent diseases that can cause chronic disease states such as post-thrombotic syndrome (PTS). In 2009 the JUPITER trial demonstrated that rosuvastatin may be effective when dealing with vascular inflammation by providing an anti-inflammatory effect. Multiple subsequent studies have looked at this association with some promising findings. The mechanism of action for statins is not entirely understood but there has been a variety of proposals and subsequent testing of inflammatory biomarkers. Additional prospective trials are needed to confirm the possible benefit of VTE reduction through an anti-inflammatory effect, but if this can be shown then statins may become a safe adjunctive therapy for VTE prevention.
他汀类药物的抗炎作用可能尚未得到充分利用,尤其是在减少静脉血栓栓塞事件方面。目前针对血栓形成事件的治疗主要依靠肝素、华法林或新型口服抗凝药进行抗凝。血栓切除术等介入手术也可能起关键作用。不幸的是,尽管进行了细致的抗凝治疗,血栓形成事件仍可能发生并复发。静脉血栓栓塞症(VTE)包括深静脉血栓形成(DVT)和肺栓塞(PE),这两种复杂且常见的疾病可导致诸如血栓后综合征(PTS)等慢性疾病状态。2009年的JUPITER试验表明,瑞舒伐他汀通过提供抗炎作用,在应对血管炎症时可能有效。随后的多项研究探讨了这种关联,并取得了一些有前景的发现。他汀类药物的作用机制尚未完全明确,但已经有各种相关提议以及对炎症生物标志物的后续检测。需要更多前瞻性试验来证实通过抗炎作用减少VTE的潜在益处,但如果能够证实这一点,那么他汀类药物可能成为预防VTE的一种安全辅助治疗方法。