Pleiotropic effects of statins: do they matter?

Treatment with the 3-hydroxy-3-methylglutaryl coenyzme A reductase inhibito rs (or statins) reduces the risk for cardiovascular events across a broad s pectrum of patient profiles, as evidenced by both primary prevention and se condary prevention trials. Improved survival by way of reduced deaths from coronary heart disease was also reported with these agents, which are prima rily indicated for substantial reduction in LDL-cholesterol levels. However , the statins are extremely complex drugs and exhibit a wide variety of vas cular effects that may or may not be dependent on their lipid-modifying pro perties. These so-called pleiotropic effects include alterations of endothe lial function, inflammation, coagulation, and plaque stability. The relativ e contribution of the nonlipid effects of statin therapy to the well-docume nted clinical benefits is currently under intense investigation. Curr Opin Lipidol 12:391-394, (C) 2001 Lippincott Williams & Wilkins.