Statins in clinical practice
Abstract
This review discusses statin treatment in patients with coronary heart disease (CHD), including acute coronary syndrome (ACS), based on the results of the latest clinical trials. The modern views on statin mechanisms of action are presented, including their pleiotropic effects, important for CHD and ACS treatment. Currently, the most effective and safe statin is atorvastatin.
About the Authors
A. S. Sivkov
I.M. Sechenov Moscow Medical Academy
Russian Federation
Russian Federation
S. V. Paukov
Moscow City Clinical Hospital No. 23. Moscow
Russian Federation
Russian Federation
V. G. Kukes
I.M. Sechenov Moscow Medical Academy
Russian Federation
Russian Federation
S. I. Sivkov
I.M. Sechenov Moscow Medical Academy
Russian Federation
Russian Federation
References
1. Arutyunov G.P. Statiny i ostryi koronarnyi sindrom: My na poroge novogo standarta lecheniya. Serdtse. 2002; 1(1): 44-6.
2. Zhdanov G.G., Sokolov I.M., Shvarts Yu.G. Intensivnaya terapiya ostrogo infarkta miokarda. Chast' 1. Vest. intens. ter. 1996; 4: 15-7.
3. Kulev B.D., Ageev F.T. Vliyanie razlichnykh podkhodov terapii statinami u patsientov vysokogo riska s tochki zreniya sosudistogo endoteliya. Kardiologiya 2009; 5: 4-10.
4. Laguta P.S., Panchenko E.P. Rol' aspirina v lechenii i profilaktike serdechno-sosudistykh zabolevanii (obzor literatury). Angiol. i sosud. khirurg. 2002; 7(3): 6-12.
5. Mareev V.Yu., Belenkov Yu.N., Oganov R.G., Barbik-Zhagar B. Atorvastatin v lechenii patsientov s ishemicheskoi bolezn'yu serdtsa i dislipidemiei i vysokim obshchim riskom: otsenka effektivnosti i bezopasnosti. Dizain i osnovnye rezul'taty issledovaniya ATLANTIKA. Kardiologiya 2008; 11: 4-13.
6. Sidorenko B.A., Preobrazhenskii D.V. Antitromboticheskie preparaty, primenyaemye dlya lecheniya serdechno-sosudistykh zabolevanii. Kardiologiya. 1996; 5: 74-85.
7. Susekov A.V., Zubareva M.Yu., Tripoten' M.I. i dr. Randomizirovannoe issledovanie "Farvater": effekt atorvatstatina 10 i 20 mg/sut. na uroven' lipidov, Reaktivnogo belka i fibrinogena u bol'nykh s IBS i dislipidemiei. RMZh 2006; 14(6): 1-6.
8. Susekov A.V., Rozhkova T.A., Tripoten' M.I. i dr. Randomizirovannoe issledovanie FARVATER: Effekt atorvastatina na funktsiyu endoteliya, rastyazhimost' i zhestkost' sosudistoi stenki. Kardiovask. ter. profil. 2007; 6(3): 68-75.
9. Yavelov I.S. Sovremennye podkhody k rannemu lecheniyu ostrogo infarkta miokarda. RMZh 1998; 6(2): 72-82.
10. Altieri D.S. Statins benefits begin to sprout. J Clin Invest 2001; 108: 365-6.
11. Aviram M., Hussein O., Rosenblat M. et al. Interactions of platelets, macrophages, and lipoproteins in hypercholesterolemia: antiatherogenic effects of HMG-CoA reductase inhibitor therapy. J Cardivasc Pharmacol 1998; 31: 39-45.
12. Aviram M., Rosenblat M., Bisgaier C. et al. Atorvastatin and gemfibrozil metabolites, but not the parent drugs, are potent antioxidants against lipoprotein oxidation. therosclerosis 1998; 271: 80.
13. Axel D.I., Riessen R., Runge H. et al. Effects of cerivastatin on human arterial smooth muscle cell proliferation and migration in transfilter cocultures. J Cardiovasc Pharmacol 2000; 35: 619-29.
14. Badaei S., Picard P., Ravandi A. et al. Blokade of endothelin receptors in LDL receptor deficient mice: role of endothelin in macrophage foam cell formation. Cardiovasc Res 2000; 48: 158-67.
15. Bustos S., Hernandes-Presa M.A., Ortego M. et al. HMG-CoA reductase inhibition by atorvastatin reduces neointimal inflammation in a rabbit model of atherosclerosis. JACC 1998; 32: 2057-64.
16. Comparison of Intensive and Moderate Lipid Lowering with Statins after Acute Coronary Syndromes/Pravastatin or Atorvastatin Evaluation and Infection Therapy -Thrombolysis in Myocardial Infarction 22 Investigators (PROVE IT -TIMI 22). N Eng J Med 2004; 350: 1495-504.
17. Conti C.R. Updated pathophysiologic concepts in unstable coronary artery disease. Am Heart J 2001; 141(2 Suppl): SI 2-4.
18. Corsini A., Pazzucconi F., Amaboldi L. et al. Direct effects of statins on the vascular wall. J Cardiovasc Pharmacol 1998; 31: 773-8.
19. Cruz-Fernandez J.M., Loez G. -Aranda V. et al. Managing acute myocardial infarction: clinical implications of the TIM study. Eur Heart J 1999; 1 (Suppl. F): F12-8.
20. Darius H., Dessy C., Nelson D.R. et al. Accelerated inhibition of platelet activity by clopidogrel loading dose in patients following coronary stent implantation. Eur Heart J 1999; 20: Abstr: Suppl: 252.
21. O'Driscoll G., Green D., Taylor R.R. Simvastatin, an HMG-coenzymeA reductaze inhibitor, improve endothelial function within 1 month. Circulation 1997; 95: 1126-31.
22. Feron O., Dessy C., Desager J.P. et al. Hydroxymethylglutarylconezyme A reductase inhibition promotes endothelial nitric oxide synthase activation through a decrease in caveolin abundance. Circulation 2001; 103: 113-8.
23. Napkeu G.J., Sudlow C.L., Dunbabin D.W. Thienopyridine Derivatives (Ticlopidine, Clopidogrel) versus Aspirin in Preventing Stroke and Other Serious Vascular Events in High Vascular Risk Patients, issue 2, update software. Oxford, UK: The Cochrane Library, 2000.
24. Hoffmann U., Yanar A., Holinger A. The frequency histogram -A new method for the evaluation of Laser Doppler Flux Motion. Microvascul Res 1990; 40: 293-301.
25. Inoue I., Goto S., Mizotani K. et al. Lipophilic HMG-CoA reductase inhibitor has an anti-inflammatory effects: Reductionof mRNA levels for interleukin-loc, interleukin-6, cyclooxygenase-2, and p22phox by regulation of peroxisome proliferator-activated receptor a (PPARa) in primary endothelial cells. Life Sci 2000; 67: 863-76.
26. Katznelson S., Wang X.M., Chia D. et al. The inhibitory effects of pravastatin on natural killer cell activity in vivo and on cytotoxic T-lymphocyte activity in vitro. J Heart Lung Transplant 1998; 17: 335-40.
27. Labarere S.A., Lee J.V., Nelson D.R. et al. C-reactive protein arterial endothelial activation, and development of transplantant coronary artery disease: a prospective study. Lancet 2002; 360: 1462-7.
28. Laufs U., La Fata V., Plutzky J., Liao J.K. Upregulation of endothelial nitric oxide synthase by HMG-CoA reductase inhibitors. Circulation 1998; 97: 1129-35.
29. Laufs U., Gertz K., Huang P. et al. Atorvastatin upregulates type III nitric oxide synthase in thrombocytes, decreates platelet activation, and protects from cerebral ischemia in normocholesterolemic mice. Stroke 2000; 31: 2437-49.
30. Laufs U., Kitler N., Konkol C. et al. Impact of HMG CoA reductase inhibition on small in the heart. Cardiovasc Res 2002; 53: 911-20.
31. Lehr H.A., Seemuller J., Hubner C. et al. Oxidized LDL-induced leukocyte/endothelium interaction in vivo involves the receptor for platelet-activating factor. Arterioscler Thromb 1993; 13: 1013-8.
32. Myocardial infarction redefined -A consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. Eur Heart J 2000; 21: 1505-18.
33. Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACLE) Study Investigators. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes. JAMA 2001; 285: 1711-8.
34. Corsini A., Pazzucconi F., Amaboldi L. et al. Direct effects of statins on the vascular wall. J Cardiovasc Pharmacol 1998; 31: 773-8.
35. Park H.J., Galper J.B. 3-hydroxy-3-methylglutaryl CoA reductase inhibitors up-regulate transforming growthfactor-beta signaling in cultured heart cells via inhibition of geranylgeranylation of RhoA GTPase. Proc Natl Acad Sci USA 1999; 96: 11525-30.
36. Pasceri V., Willerson J.T., Yeh E.T. Direct proinflammatory effects of C-reactive protein on human endothelial cells. Circulation 2000; 102: 2165-8.
37. Pedersen A.K., FitzGerald G.A. Dose-related kinetics of aspirin: presystemic acetylation of platelet cyclooxygenase. N Engl J Med 1984; 311:1206-11.
38. Pepper M.S. Role of the matrix metalloproteinase and plasminogen activator-plasmin systems in angiogenesis. Arterioscler Thromb Vase Biol 2001; 21: 1104-17.
39. Pepys M.B., Hirschfield G.M., Tennent G.A. et al. Targeting C-reactive protein for the treatment of cardiovascular disease. Nature 2006; 440: 1217-21.
40. Plehn J.F., Davis B.R., Sacks F.M. et al. for the CARE Invesgators. Reduction of stroke incidence after myocardial infarction with pravastatin: the CARE study. Circulation 1999; 99: 216-23.
41. Prevention of cardiovascular events and death with pravastatin in patient with coronary heart disease and a broad range of initial cholesterol levels. The Long-term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. N Eng J Med 1998; 339: 1349-57.
42. Raiteri M., Arnaboldi L., McGeady P. et al. Pharmacological control of the mevalonate pathway: effect on arterial smooth muscle cell proliferation. J Pharmacol Exp Ther 1997; 281: 1144-5.
43. Rossen R.D. HMG-CoA reductase inhibitors: a new class of antiinflammatory drugs. JACC 1997; 30: 1218-9.
44. Ross A., Molhoek P., Lundergan S. et al. Randomized Comparison of Enoxaparin Low-Molecular-Weight Heparin With Unfractionated Heparin Adjunctive to Recombinant Tissue Plasminogen Activator Thrombolysis and Aspirin Second Trial of Heparin and Aspirin Reperfusion Therapy (HART II). Circulation 2001; 104: 648-52.
45. Savcic M., Hauert J., Bachmann F. et al. Clopidogrel Loading Dose Regimens: Kinetic Profile of Pharmacodynamic Response in Healthy Subjects. Semin Thromb Hemost 1999; 25(Suppl 2): 15-9.
46. Schwartz G.G., Olsson A.G., Ezekovitz M.D. et al. Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACLE) Study Investigators. Effects of Atorvastatin on early recurrent Ischemic Events in acute Coronary Syndromes. JAMA 2001; 285: 1711-8.
47. Weitz J.V., Hirch J. New antithrombotic agents. Chest 1998; 113 (Suppl): 715-27.
48. White H.D., Simes J., Anderson N.E. et al. Pravastatin therapy and the risk of stroke. N Engl J Med 2000; 343: 317-26.
49. Wilcox J.N., Smith K.M., Schwartz S.M., Gordon D. Localization of tissue Factor in normal vessel wail end in the atherosclerotic plaque. Proc Natl Acad Sci USA 1989; 86: 2839-43.
50. Yancopoulos G.P., Davis S., Gale N.W. et al. Vascular-specific growth factors and blood vessel formation. Nature 2000; 407: 242-8.
Review
For citations:
Sivkov A.S., Paukov S.V., Kukes V.G., Sivkov S.I. Statins in clinical practice. Cardiovascular Therapy and Prevention. 2010;9(2):100-107. (In Russ.)
Views:
570
ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)
ISSN 2619-0125 (Online)
Email this article 
