Pleiotropic Effects of Statins: Lipid Reduction and Beyond

Abstract

There is accumulating evidence that statins have beneficial effects that are independent of their classical actions on lipoproteins. These effects include reductions in inflammation in the vasculature, kidney, and bone. Potential beneficial effects of these agents include enhancement of nitric oxide production in vasculature and the kidney. These agents appear to reduce bone fractures and may improve insulin sensitivity and reduce the likelihood of persons progressing from impaired glucose tolerance to type II diabetes. Potential beneficial pleiotropic effects of statins are covered in this review.

Secondary Prevention After Coronary Artery Bypass Graft Surgery

“…93,94 These cholesterol-independent or "pleiotropic" properties include improvements in endothelial function, nitric oxide levels, and antioxidant activity, as well as the inhibition of inflammatory responses, vasoconstriction, thrombosis, and platelet aggregation. [94][95][96][97][98] Administering statins before surgery has been shown to diminish the systemic inflammatory response associated with the use of cardiopulmonary bypass during CABG. [99][100][101][102] Through antisympathetic activity and the stabilization of ion channels, 103 both randomized and observational studies have illustrated that statin treatment significantly reduces the risk of AF after CABG both in the perioperative period and long term after surgery.…”

Statins and New-Onset Diabetes in Cardiovascular and Kidney Disease Cohorts: A Meta-Analysis

“…Over 25% of Americans over the age of 45 years are prescribed a statin according to a CDC study from 2010 [3]. The role of statins in reducing the number one cause of death worldwide – that is, cardiovascular disease (CVD) – has been well established, dating back to the 1980s [4]. Indications for statins continue to expand, likely due to their observed and evolving pleotropic effects above and beyond the lipid-lowering effects that have been observed in several randomized controlled trials [4-6].…”

“…The role of statins in reducing the number one cause of death worldwide – that is, cardiovascular disease (CVD) – has been well established, dating back to the 1980s [4]. Indications for statins continue to expand, likely due to their observed and evolving pleotropic effects above and beyond the lipid-lowering effects that have been observed in several randomized controlled trials [4-6]. Statins are effective and have shown to be responsible for a 60% risk reduction in ischemic heart disease [7].…”

“…Statins are effective and have shown to be responsible for a 60% risk reduction in ischemic heart disease [7]. In addition, being widely available in generic forms, statins are cost-effective means for reducing CVD risk in large populations, particularly among high-risk groups such as people with diabetes and kidney disease, thus reducing global mortality [4, 8, 9]. In addition to their benefits, adverse effects have also been established, most notably myopathy [10, 11] and perhaps liver disease, although emerging data indicate that statins induce a reduction in the extent of hepatic steatosis [12-15].…”

“…Statins were initially thought to reduce the risk of incident diabetes [4, 16], based on the retrospective analysis of the West of Scotland Coronary Prevention Study (WSCOPS), which examined the development of new diabetes mellitus in men aged 45–64 years [16]. In this study, a total of 5,974 of the 6,595 randomized subjects were included in the analysis, and the assignment to pravastatin therapy resulted in a 30% reduction ( p = 0.042) in the hazard of developing diabetes [16].…”