Jadwiga Mielcarek, Paweł Grobelny, Róża Zych, Magdalena Kulay
Czy statyny okażą się najpopularniejszą grupą leków?
Whether statins turn out to be the most popular drug group? The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, also called statins, are a well-established class of drugs in the treatment of hypercholesterolemia, and members of this class have been shown to reduce the risk of cardiovascular morbidity and mortality in patients at risk for coronary heart disease. Despite the LDL cholesterol-lowering ability of statins that is probably responsible for most of their coronary events and stroke prevention benefit, the full benefit of these drugs may be partly the result of other mechanisms including antiproliferative effects on smooth muscle cells, restoration of endothelial activity, antithrombotic, antioxidant, and anti-inflammatory effects. These effects may offer protection against atherosclerotic plaque growth and precipitation of acute events. These properties, collectively referred to as nonlipid or pleiotropic effects, may differ from one statin to another. Except for simvastatin (SV) and lovastatin (LV), all currently available statins are administered as the pharmacologically active hydroxyl acid forms. SV and LV are inactive d-lactones. All statins undergo varying degrees of metabolism in both animals and humans catalyzed primarily by the cytochrome P 450 system. Now, the statins are a group of cholesterol-lowering agents that have became some of the largest selling drugs in the world.