Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL 60637, USA.
Department of Cardiovascular Care, ThedaCare Regional Medical Center, Appleton, WI, USA.
Cardiovasc Res. 2022 Jan 29;118(2):413-423. doi: 10.1093/cvr/cvab032.
Over the past four decades, no class of drugs has had more impact on cardiovascular health than the 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors or statins. Developed as potent lipid-lowering agents, statins were later shown to reduce morbidity and mortality of patients who are at risk for cardiovascular disease. However, retrospective analyses of some of these clinical trials have uncovered some aspects of their clinical benefits that may be additional to their lipid-lowering effects. Such 'pleiotropic' effects of statins garnered intense interest and debate over its contribution to cardiovascular risk reduction. This review will provide a brief background of statin pleiotropy, assess the available clinical evidence for and against their non-lipid-lowering benefits, and propose future research directions in this field.
在过去的四十年中,没有一类药物对心血管健康的影响能超过 3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂或他汀类药物。他汀类药物最初被开发为强效的降脂药物,后来被证明可以降低心血管疾病风险患者的发病率和死亡率。然而,对这些临床试验中的一些回顾性分析揭示了它们的一些临床益处,这些益处可能除了降脂作用之外还有其他作用。他汀类药物的这种“多效性”作用引起了人们的极大兴趣,并引发了关于其对降低心血管风险贡献的激烈争论。本文将简要介绍他汀类药物的多效性,评估现有关于其非降脂作用的临床证据,并提出该领域的未来研究方向。