The clinical benefits of statins are strongly related to their low density lipoprotein-cholesterol (LDL-C) lowering properties. However, because mevalonic acid (MVA), the product of 3-hydroxy-3-methyl-3-glutaryl coenzyme A (HMG-CoA) reductase reaction, is the precursor not only of cholesterol but also of nonsteroidal isoprenoid compounds, the inhibition of HMG-CoA reductase may result in pleiotropic effects, independent of their hypocholesterolemic properties. The discrimination between the pleiotropic from LDL-C lowering effects may potentially be more evident during the early phase of treatment since plasma MVA levels drop up to 70% within 1-2 hours while a reduction of LDL-C, detectable after 24 hours, became significant after 6-7 days. Therefore, the deprivation of circulating MVA-derived isoprenoids in the early phase of treatment could be the main mechanism responsible for the atheroprotective effect of statins. This early window of protection in the absence of LDL-C lowering suggests that the anti-inflammatory and the pleiotropic properties of statins may have clinical importance. Therefore, acute coronary syndromes could represent a clinical condition for addressing the early benefits of statins therapy, ie, within 24 h of the event, independent of LDL-C lowering.

Are pleiotropic effects of statins real? [Recensione] / A. Corsini, N. Ferri, M. Cortellaro. - In: VASCULAR HEALTH AND RISK MANAGEMENT. - ISSN 1176-6344. - 3:5(2007), pp. 611-613.

Are pleiotropic effects of statins real?

A. Corsini;N. Ferri;M. Cortellaro
2007

Abstract

The clinical benefits of statins are strongly related to their low density lipoprotein-cholesterol (LDL-C) lowering properties. However, because mevalonic acid (MVA), the product of 3-hydroxy-3-methyl-3-glutaryl coenzyme A (HMG-CoA) reductase reaction, is the precursor not only of cholesterol but also of nonsteroidal isoprenoid compounds, the inhibition of HMG-CoA reductase may result in pleiotropic effects, independent of their hypocholesterolemic properties. The discrimination between the pleiotropic from LDL-C lowering effects may potentially be more evident during the early phase of treatment since plasma MVA levels drop up to 70% within 1-2 hours while a reduction of LDL-C, detectable after 24 hours, became significant after 6-7 days. Therefore, the deprivation of circulating MVA-derived isoprenoids in the early phase of treatment could be the main mechanism responsible for the atheroprotective effect of statins. This early window of protection in the absence of LDL-C lowering suggests that the anti-inflammatory and the pleiotropic properties of statins may have clinical importance. Therefore, acute coronary syndromes could represent a clinical condition for addressing the early benefits of statins therapy, ie, within 24 h of the event, independent of LDL-C lowering.
Settore MED/09 - Medicina Interna
Settore BIO/14 - Farmacologia
VASCULAR HEALTH AND RISK MANAGEMENT
http://dovepress.com/articles.php?content_id=1657
Article (author)
File in questo prodotto:
File Dimensione Formato  
VHRM statins.pdf

accesso aperto

Tipologia: Publisher's version/PDF
Dimensione 56.24 kB
Formato Adobe PDF
56.24 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/33803
Citazioni
  • ???jsp.display-item.citation.pmc??? 5
  • Scopus 34
  • ???jsp.display-item.citation.isi??? ND
social impact