Pleiotropic Effects of Statins-What is their Clinical Significance?

Walter F. Riesen
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Abstract

Pleiotropic effects are effects not related to the primary effect of drugs. Statins, beside their primary effect, which is LDL-lowering, have several pleiotropic effects, such as anti-inflammation, anti-thrombotic effects, inhibition of smooth muscle cell proliferation and apoptosis, inhibition of migration and activation of macrophages. They increase blood glucose with the exception of pitavastatin. The clinical importance of these pleiotropic effects of statins however remains unclear. No matter of whether LDL-lowering was done by statins or by other means, the lowering of the cardiovascular risk is the same. The reduction in LDL-C per se is responsible for the beneficial effect. However, pleiotropic effects of statins might play a role with respect to micro vascular events. The difference in pleiotropic effects between the different statins might be a basis for a patient-oriented statin therapy.
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他汀类药物的多效作用——其临床意义?
多效效应是指与药物原效无关的效应。他汀类药物除了具有降低ldl的主要作用外,还具有抗炎症、抗血栓形成、抑制平滑肌细胞增殖和凋亡、抑制巨噬细胞迁移和活化等多种作用。除了匹伐他汀,它们会增加血糖。然而,他汀类药物这些多效性的临床重要性尚不清楚。无论是通过他汀类药物还是其他方法降低ldl,降低心血管风险的效果都是一样的。LDL-C的降低本身就是有益效果的原因。然而,他汀类药物的多效性可能在微血管事件中起作用。不同他汀类药物的多效性差异可能是他汀类药物以患者为导向治疗的基础。
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