Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Cardiac Surgery, Centre Cardiologique du Nord de Saint Denis, Paris, France.
Biomed Res Int. 2021 Jan 23;2021:6661847. doi: 10.1155/2021/6661847. eCollection 2021.
Statins are a class of drugs widely used in clinical practice for their lipid-lowering and pleiotropic effects. In recent years, a correlation between statins and platelet function has been unveiled in the literature that might introduce new therapeutic indications for this class of drugs. This review is aimed at summarizing the mechanisms underlying statin-platelet interaction in the cardiologic scenario and building the basis for future in-depth studies.
We conducted a literature search through PubMed, Embase, EBSCO, Cochrane Database of Systematic Reviews, and Web of Science from their inception to June 2020.
Many pathways could explain the interaction between statins and platelets, but the specific effect depends on the specific compound. Some could be mediated by enzymes that allow the entry of drugs into the cell (OATP2B1) and others by enzymes that mediate their activation (PLA2, MAPK, TAX2, PPARs, AKT, and COX-1), recruitment and adhesion (LOX-1, CD36, and CD40L), or apoptosis (BCL2). Statins also appear to have a synergistic effect with aspirin and low molecular weight heparins. Surprisingly, they seem to have an antagonistic effect with clopidogrel.
There are many pathways potentially responsible for the interactions between statins and platelets. Their effect appears to be closely related, and each single effect can be barely measured. Also, the same compound might have complex downstream signaling with potentially opposite effects, i.e., beneficial or deleterious. The multiple clinical implications that can be derived as a result of this interaction, however, represent an excellent reason to develop future in-depth studies.
他汀类药物是一类在临床实践中广泛用于降低血脂和发挥多效作用的药物。近年来，文献中揭示了他汀类药物与血小板功能之间的相关性，这可能为这类药物带来新的治疗适应症。本综述旨在总结他汀类药物与血小板相互作用的机制，并为未来的深入研究奠定基础。
我们通过 PubMed、Embase、EBSCO、Cochrane 系统评价数据库和 Web of Science 从其成立到 2020 年 6 月进行了文献检索。
许多途径可以解释他汀类药物与血小板之间的相互作用，但具体的作用取决于特定的化合物。一些途径可能通过允许药物进入细胞的酶来介导（OATP2B1），而其他途径可能通过激活药物的酶来介导（PLA2、MAPK、TAX2、PPARs、AKT 和 COX-1）、募集和黏附（LOX-1、CD36 和 CD40L）或凋亡（BCL2）。他汀类药物似乎还与阿司匹林和低分子量肝素具有协同作用。令人惊讶的是，它们似乎与氯吡格雷具有拮抗作用。
有许多途径可能导致他汀类药物与血小板之间的相互作用。它们的作用似乎密切相关，并且每种单一作用都难以测量。此外，同一化合物可能具有复杂的下游信号通路，具有潜在的相反作用，即有益或有害。由于这种相互作用可以衍生出许多临床意义，因此非常有必要开展进一步的深入研究。
