Statins in acute coronary syndromes.

Published on Nov 30, 2017in Current Pharmaceutical Design2.208
· DOI :10.2174/1381612823666170816114403
Manolis Vavuranakis29
Estimated H-index: 29
(UoA: National and Kapodistrian University of Athens),
Maria Kariori10
Estimated H-index: 10
(UoA: National and Kapodistrian University of Athens)
+ 2 AuthorsDimitris Tousoulis81
Estimated H-index: 81
(UoA: National and Kapodistrian University of Athens)
BACKGROUND: Patients with acute coronary syndrome (ACS) frequently experience recurrent adverse events from the cardiovascular system comparing to either healthy individuals or individuals with stable coronary artery disease. This is attributed to the inflammatory cascade that is activated during ACS resulting in increased risk for rupture of vulnerable plaques. OBJECTIVE: Therefore, it is of great importance to avoid recurrent events with treatment aiming at secondary prevention which includes the management of lipid profile besides alteration in the lifestyle and habits. METHODS: This review will present current data concerning present status of treatment with statins, and refer to non-statin strategies as well as novel and promising agents for the secondary prevention therapy after ACS. A thorough search of PubMed and the Cochrane Database was conducted in order to identify the majority of trials, studies, current guidelines and novel articles related to the subject. RESULTS: Statins have been proved to play very significant role in the part of secondary prevention since they decrease the burden of atherosclerotic plaques, the risk of adverse events and the need for revascularization in symptomatic patients with CAD. Therefore, they were established and suggested by both European and American guidelines as first-line treatment option for lipid-lowering management. Several clinical trials, meta- analyses and randomized trials strongly recommended the application of early and intensive treatment with statins in patients with ACS. Nevertheless, a vast majority of individualsneither tolerated statins nor achieved the optimal value for LDL-C with the highest tolerated dose of statins resulting in poor clinical outcome. Furthermore, recent clinical trials indicated further benefit of combined treatment of statins with non-statins drugson the decrease of cardiovascular events as well asprogress of coronary artery plaque. Finally, novel agentsthat are still evaluated with ongoing clinical trials have been turned into a very promising treatment option. CONCLUSION: In conclusion, statins are established as the first-line treatment for the secondary prevention after acute coronary syndromes in order to avoid the recurrence of thrombotic events. However, the research field on the field of lipid-lowering therapies is still ongoing and very promising for the future.
📖 Papers frequently viewed together
3 Citations
1 Citations
5 Citations
Cited By2
#1Anida Velagic (Monash University)H-Index: 2
#2Chengxue Qin (Monash University)H-Index: 17
Last. Barbara K Kemp-Harper (Monash University)H-Index: 29
view all 6 authors...
Diabetes is associated with an increased mortality risk due to cardiovascular complications. Hyperglycemia-induced oxidative stress underlies these complications, leading to an impairment in endogenous nitric oxide (NO.) generation, together with reductions in NO. bioavailability and NO. responsiveness in the vasculature, platelets and myocardium. The latter impairment of responsiveness to NO., termed NO. resistance, compromises the ability of traditional NO.-based therapeutics to improve hemody...
5 CitationsSource
#1Evangelos Oikonomou (UoA: National and Kapodistrian University of Athens)H-Index: 32
#2Gerasimos Siasos (UoA: National and Kapodistrian University of Athens)H-Index: 48
Last. Dimitris Tousoulis (UoA: National and Kapodistrian University of Athens)H-Index: 81
view all 17 authors...
: Coronary artery disease is the leading cause of morbidity and mortality worldwide. The most common pathophysiologic substrate is atherosclerosis which is an inflammatory procedure that starts at childhood and develops throughout life. Endothelial dysfunction is associated with the initiation and progression of atherosclerosis and is characterized by the impaired production of nitric oxide. In general, endothelial dysfunction is linked to poor cardiovascular prognosis and different methods, bot...
7 CitationsSource