The Ohio State University, College of Medicine, Department of Biological Chemistry and Pharmacology, Columbus, OH 43210, United States.
Charles Drew University, School of Medicine, Los Angeles, CA 90059, United States.
Curr Vasc Pharmacol. 2019;17(3):239-261. doi: 10.2174/1570161116666180723120608.
Statins are effective for primary and secondary prevention of atherosclerotic cardiovascular disease. They also have systemic anti-inflammatory and immunomodulating properties suggesting potential utility for improving clinical outcomes for a wide range of diseases. The literature provides data suggesting benefit in patients with comorbidities associated with contrast-induced nephropathy (CIN), chronic obstructive pulmonary disease (COPD), pneumonia, head injury, neurological disease (e.g. Alzheimer's and Parkinson's disease), prostate cancer, nuclear cataract and spinal cord injury. This systematic review evaluates the current evidence supporting the potential benefit of statins outside their customary role of attenuating cardiovascular risk reduction.
The electronic databases MEDLINE, EMBASE, and clinicaltrials.gov were searched for studies published January 2000 - March 2018 reporting comorbidity reduction associated with statin use.
Fifty-eight publications that satisfied our selection criteria (based on the PRISM guidance for systematic reviews) were selected and included case-control, cohort, cross-sectional and observational studies as well as systematic reviews and meta-analyses. Ten studies addressed statin use and incidence of CIN after coronary imaging; 8 addressed statin use in patients with COPD; 14 addressed statin use and comorbidity reduction associated with head injury and/or a neurological disease disorder; 5 addressed the association between statin use and nuclear cataract; 9 addressed the association between statin use and prostate/colorectal cancer; 9 studies addressed the role of statin use in treating infections; and 3 addressed the association between statin use and spinal cord injury related survival rate.
Overall, the literature supports beneficial pleiotropic effects of statin use in contrastinduced nephropathy, head injury, Alzheimer's and Parkinson's disease, nuclear cataract, prostate cancer, infection management, and spinal cord injury. Further investigation is warranted, and randomized clinical trials are needed to confirm the clinical utility suggested by the reported studies included in this meta-analysis.
他汀类药物对动脉粥样硬化性心血管疾病的一级和二级预防均有效。它们还具有全身性抗炎和免疫调节作用，这表明它们可能对改善多种疾病的临床结局有一定作用。文献提供的数据表明，在伴有造影剂肾病（CIN）、慢性阻塞性肺疾病（COPD）、肺炎、头部损伤、神经疾病（如阿尔茨海默病和帕金森病）、前列腺癌、核性白内障和脊髓损伤等合并症的患者中，他汀类药物具有获益。本系统评价评估了支持他汀类药物在降低心血管风险以外的常规作用之外具有潜在益处的现有证据。
检索了 MEDLINE、EMBASE 和 clinicaltrials.gov 电子数据库，以获取 2000 年 1 月至 2018 年 3 月期间发表的与他汀类药物使用相关的减少合并症的研究报告。
根据系统评价 PRISM 指南的选择标准，共选择了 58 篇满足入选标准的文献，包括病例对照、队列、横断面和观察性研究以及系统评价和荟萃分析。10 项研究评估了冠状动脉成像后 CIN 与他汀类药物使用的关系；8 项研究评估了 COPD 患者中他汀类药物的使用；14 项研究评估了头部损伤和/或神经疾病与他汀类药物使用减少合并症的关系；5 项研究评估了他汀类药物使用与核性白内障之间的关系；9 项研究评估了他汀类药物使用与前列腺/结直肠癌之间的关系；9 项研究评估了他汀类药物在治疗感染方面的作用；3 项研究评估了他汀类药物使用与脊髓损伤相关生存率之间的关系。
总体而言，文献支持他汀类药物在 CIN、头部损伤、阿尔茨海默病和帕金森病、核性白内障、前列腺癌、感染管理和脊髓损伤方面具有有益的多效性作用。需要进一步的研究，并且需要进行随机临床试验来证实本荟萃分析中报告的研究所提示的临床实用性。
