Current advances in statin treatment: From molecular mechanisms to clinical practice

Statins inhibit cholesterol biosynthesis and are beneficial in the primary and secondary prevention of cardiovascular disease. In some studies, the benefits of statin therapy appear to be greater and to occur much earlier than what might be expected from changes in lipid levels alone. Indeed, statins inhibits the synthesis of isoprenoids, which are important lipid attachments for intracellular signaling molecules such as Rho, Rac, and Cdc42. Inhibition of these signaling molecules may contribute to some of the cholesterol-independent or "pleiotropic" effects of statins. These effects include improvement in endothelial function, stabilization of atherosclerotic plaques, reduction of inflammation and oxidative stress, and inhibition of thrombogenic response. Thus, the overall benefits of statin therapy in cardiovascular disease may be due to cholesterol-dependent and -independent mechanisms.