ARE THERE POTENTIAL NON-LIPID-LOWERING USES OF STATINS

Recent clinical trials have demonstrated beyond doubt that statins are effective in the prevention of acute coronary events. Critical analys is of these studies suggests that the benefits of statin therapy canno t be fully explained on the basis of reductions in plasma cholesterol levels. Accumulating knowledge of the actions of these drugs shows tha t they may prevent several processes that eventually lead to plaque ru pture and the development of occlusive thrombosis, the basis of acute coronary events. Hence, statins may correct endothelial dysfunction (t hus protecting against ischaemic injury), stabilise existing plaques a nd modify the coagulation pathway, thereby reducing the likelihood of a sudden vascular event. At a cellular level, these drugs inhibit the synthesis not just of cholesterol, but of other compounds important in cell proliferation. Antiproliferative effects have been demonstrated in vitro and may broaden the applications of statins to the treatment of noncardiovascular diseases. Finally, preliminary clinical studies i ndicate that as a result of immunosuppressive actions, statins may red uce the incidence of rejection following organ transplantation.