A Review of the Role of Statins in Heart Failure Treatment

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics Current clinical pharmacology Pub Date : 2020-03-31 DOI:10.2174/1574884714666190802125627
M. Niazi, N. Galehdar, M. Jamshidi, R. Mohammadi, Alireza Moayyedkazemi
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引用次数: 11

Abstract

Background Heart failure is a common medical problem in the world, which has a high prevalence in both developed and developing countries. Today, among the medications used for the heart failure treatment, there are many medications with a positive cardiac contraction effect (positive inotropic such as digital glycosides, adrenergic receptor stimulants, and phosphodiesterase inhibitors), a large number of cardiac diluents (such as Angiotensin-Converting Enzyme (ACE) inhibitor group), and a few other types of drugs whose final effects are still under review. Statins are valuable drugs that are broadly prescribed in hyperlipidemia and cardiovascular patients due to their multiple properties, such as cholesterol reduction, endothelial function improvement, anti-oxidative, anti-inflammatory, neovascularization, and immunomodulatory activities. Methods There is evidence that the therapeutic role of statins in HF, due to myocardial hypertrophy, show reduction in cardiomyocyte loss in the apoptosis process, oxidative stress, inflammation, and also the return of neurohormonal imbalance. However, the fact that these drugs have no side-effects has not been confirmed in all studies, as statins prevent the production of particular beneficial and protective factors, such as coenzyme Q10 (CoQ10), while inhibiting the production of specific proteins involved in pathologic mechanisms. Results Recently, it has been hypothesized that, despite the positive effects reported, high doses of statins in patients with long-term heart failure lead to progress in heart failure by inhibiting CoQ10 synthesis and intensifying hypertrophy. Conclusion Thus, it can be stated that the advantage of using statins depends on factors, such as stroke fraction, and the existence of other standard indications such as atherosclerotic diseases or high Low-Density Lipoprotein-C (LDL-C).
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他汀类药物在心力衰竭治疗中的作用综述
背景心力衰竭是世界上常见的医疗问题,在发达国家和发展中国家都有很高的发病率。如今,在用于心力衰竭治疗的药物中,有许多药物具有积极的心脏收缩作用(正性肌力药物,如指苷类、肾上腺素能受体兴奋剂和磷酸二酯酶抑制剂),大量的心脏稀释剂(如血管紧张素转换酶(ACE)抑制剂组),以及一些其他类型的药物,其最终效果仍在审查中。他汀类药物是一种有价值的药物,由于其多种特性,如降低胆固醇、改善内皮功能、抗氧化、抗炎、新生血管形成和免疫调节活性,广泛用于高脂血症和心血管患者。方法有证据表明,他汀类药物在HF中的治疗作用,由于心肌肥大,显示出心肌细胞在凋亡过程中的损失减少,氧化应激,炎症,以及神经激素失衡的恢复。然而,这些药物没有副作用的事实并没有在所有研究中得到证实,因为他汀类药物可以阻止特定有益和保护因子的产生,如辅酶Q10(CoQ10),同时抑制参与病理机制的特定蛋白质的产生。结果最近,有人假设,尽管报道了积极的作用,但长期心力衰竭患者服用高剂量他汀类药物会通过抑制辅酶Q10的合成和加剧肥大而导致心力衰竭的进展。结论因此,可以说,使用他汀类药物的优势取决于中风分数等因素,以及是否存在其他标准适应症,如动脉粥样硬化性疾病或高密度脂蛋白-C(LDL-C)。
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来源期刊
Current clinical pharmacology
Current clinical pharmacology PHARMACOLOGY & PHARMACY-
CiteScore
3.60
自引率
0.00%
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0
期刊介绍: Current Clinical Pharmacology publishes frontier reviews on all the latest advances in clinical pharmacology. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: pharmacokinetics; therapeutic trials; adverse drug reactions; drug interactions; drug metabolism; pharmacoepidemiology; and drug development. The journal is essential reading for all researchers in clinical pharmacology.
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