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(Circulation. 2002;105:2937.)
© 2002 American Heart Association, Inc.

Editorial

Statin Therapy

Beyond Cholesterol Lowering and Antiinflammatory Effects

Alan C. Yeung, MD; Philip Tsao, PhD

From Stanford University School of Medicine, Stanford, Calif.

Correspondence to Dr Alan Yeung, Stanford University Medical Center, #2105 300 Pasteur Dr, Stanford, CA 94305. E-mail alan_yeung@ cvmed.stanford.edu

Key Words: Editorials • statins • cholesterol

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Aggressive cholesterol lowering has gradually been adopted by clinicians as part of a standard treatment regimen for patients with documented coronary artery disease, including those who have had recent bypass surgery and acute coronary syndrome.^1–3 According to the recently published National Cholesterol Education Program Adult Treatment Panel III (NCEP III) guidelines, ^3a those patients who have documented coronary disease should have their LDL cholesterol lowered to less than 100 mg/dL.

See p 3017

The clinical benefit of statin therapy is primarily attributed to its LDL-lowering (and potentially HDL-elevating) effects. A subgroup analysis, however, of large clinical trials indicates that statin-treated individuals have significantly less cardiovascular disease than patients with comparable serum cholesterol levels.^4–6 Subsequently, intriguing experimental data have shown that statins exhibit pleiotropic effects that can beneficially impact occlusive vascular disease, including inhibition of smooth muscle proliferation and platelet aggregation, enhancement of endothelial function, and antiinflammatory actions.^7–12 These effects could be due to the fact that mevalonic acid is the precursor of not only cholesterol synthesis but also of many nonsteroidal isoprenoid compounds. These signaling intermediates are thought to be important for the subcellular localization and intracellular trafficking of several membrane-bound proteins. In addition, statins can induce the phosphorylation (and activation) of the serine/threonine protein kinase, Akt. More recently, experimental evidence suggest that statins may also have oncoprotective effects by inducing certain tumor cell types, such as acute myelogenous leukemia, to undergo apoptosis in a sensitive and specific manner.^13,14 Also of interest clinically is the fact that statin therapy seems to . . . [Full Text of this Article]

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