Chonnam Med J.  2013 Apr;49(1):1-6. 10.4068/cmj.2013.49.1.1.

Role of Statins in Coronary Artery Disease

• Lim SY

• KMID: 2172169
• DOI: http://doi.org/10.4068/cmj.2013.49.1.1

Abstract

Statins have been known to significantly reduce cardiovascular events in patients with cardiovascular disease. This review was undertaken to examine the current evidence for the effect of statins in patients with coronary artery disease. Further research is needed to clarify questions concerning the optimal timing, dosage, and type of statin therapy as well as the problems associated with adverse effects.

Keyword

Hydroxymethylglutaryl-CoA reductase inhibitors; Coronary artery disease; Myocardial infarction

MeSH Terms

Cardiovascular Diseases
Coronary Artery Disease
Coronary Vessels
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Myocardial Infarction
Hydroxymethylglutaryl-CoA Reductase Inhibitors

Reference

1. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994; 344:1383–1389. PMID: 7968073.

2. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, et al. West of Scotland Coronary Prevention Study Group. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med. 1995; 333:1301–1307. PMID: 7566020.

3. Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, et al. Cholesterol and Recurrent Events Trial investigators. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med. 1996; 335:1001–1009. PMID: 8801446.

4. Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998; 279:1615–1622. PMID: 9613910.

5. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998; 339:1349–1357. PMID: 9841303.

6. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002; 360:7–22. PMID: 12114036.

7. Shepherd J, Blauw GJ, Murphy MB, Bollen EL, Buckley BM, Cobbe SM, et al. PROSPER Study Group. PROspective Study of Pravastatin in the Elderly at Risk. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002; 360:1623–1630. PMID: 12457784.

8. Sever PS, Dahlöf B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al. ASCOT Investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003; 361:1149–1158. PMID: 12686036.

9. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Cholesterol Treatment Trialists' (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005; 366:1267–1278. PMID: 16214597.

10. Cannon CP, Braunwald E, McCabe CH, Rader DJ, Rouleau JL, Belder R, et al. Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med. 2004; 350:1495–1504. PMID: 15007110.

11. Schwartz GG, Olsson AG, Ezekowitz MD, Ganz P, Oliver MF, Waters D, et al. Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA. 2001; 285:1711–1718. PMID: 11277825.

12. de Lemos JA, Blazing MA, Wiviott SD, Lewis EF, Fox KA, White HD, et al. Investigators. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA. 2004; 292:1307–1316. PMID: 15337732.

13. Ray KK, Cannon CP, McCabe CH, Cairns R, Tonkin AM, Sacks FM, et al. PROVE IT-TIMI 22 Investigators. Early and late benefits of high-dose atorvastatin in patients with acute coronary syndromes: results from the PROVE IT-TIMI 22 trial. J Am Coll Cardiol. 2005; 46:1405–1410. PMID: 16226162.

14. LaRosa JC, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC, et al. Treating to New Targets (TNT) Investigators. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med. 2005; 352:1425–1435. PMID: 15755765.

15. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. National Heart, Lung, and Blood Institute. American College of Cardiology Foundation. American Heart Association. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004; 110:227–239. PMID: 15249516.

16. Smith SC Jr, Feldman TE, Hirshfeld JW Jr, Jacobs AK, Kern MJ, King SB 3rd, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). J Am Coll Cardiol. 2006; 47:e1–e121. PMID: 16386656.

17. Jukema JW, Bruschke AV, van Boven AJ, Reiber JH, Bal ET, Zwinderman AH, et al. Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels. The Regression Growth Evaluation Statin Study (REGRESS). Circulation. 1995; 91:2528–2540. PMID: 7743614.

18. Nissen SE, Tuzcu EM, Schoenhagen P, Brown BG, Ganz P, Vogel RA, et al. REVERSAL Investigators. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA. 2004; 291:1071–1080. PMID: 14996776.

19. Okazaki S, Yokoyama T, Miyauchi K, Shimada K, Kurata T, Sato H, et al. Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. Circulation. 2004; 110:1061–1068. PMID: 15326073.

20. Nissen SE, Yock P. Intravascular ultrasound: novel pathophysiological insights and current clinical applications. Circulation. 2001; 103:604–616. PMID: 11157729.

21. Ballantyne CM, Raichlen JS, Nicholls SJ, Erbel R, Tardif JC, Brener SJ, et al. ASTEROID Investigators. Effect of rosuvastatin therapy on coronary artery stenoses assessed by quantitative coronary angiography: a study to evaluate the effect of rosuvastatin on intravascular ultrasound-derived coronary atheroma burden. Circulation. 2008; 117:2458–2466. PMID: 18378607.

22. Chan AW, Bhatt DL, Chew DP, Reginelli J, Schneider JP, Topol EJ, et al. Relation of inflammation and benefit of statins after percutaneous coronary interventions. Circulation. 2003; 107:1750–1756. PMID: 12665489.

23. Briguori C, Colombo A, Airoldi F, Violante A, Focaccio A, Balestrieri P, et al. Statin administration before percutaneous coronary intervention: impact on periprocedural myocardial infarction. Eur Heart J. 2004; 25:1822–1828. PMID: 15474697.

24. Ebrahimi R, Saleh J, Toggart E, Shah AP, Azmoon S, Babaei H, et al. Effect of preprocedural statin use on procedural myocardial infarction and major cardiac adverse events in percutaneous coronary intervention: a meta-analysis. J Invasive Cardiol. 2008; 20:292–295. PMID: 18523323.

25. Patti G, Pasceri V, Colonna G, Miglionico M, Fischetti D, Sardella G, et al. Atorvastatin pretreatment improves outcomes in patients with acute coronary syndromes undergoing early percutaneous coronary intervention: results of the ARMYDA-ACS randomized trial. J Am Coll Cardiol. 2007; 49:1272–1278. PMID: 17394957.

26. Di Sciascio G, Patti G, Pasceri V, Gaspardone A, Colonna G, Montinaro A. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention: results of the ARMYDA-RECAPTURE (Atorvastatin for Reduction of Myocardial Damage During Angioplasty) Randomized Trial. J Am Coll Cardiol. 2009; 54:558–565. PMID: 19643320.

27. Patti G, Ricottini E, Nusca A, Colonna G, Pasceri V, D'Ambrosio A, et al. Short-term, high-dose Atorvastatin pretreatment to prevent contrast-induced nephropathy in patients with acute coronary syndromes undergoing percutaneous coronary intervention (from the ARMYDA-CIN [atorvastatin for reduction of myocardial damage during angioplasty--contrast-induced nephropathy] trial. Am J Cardiol. 2011; 108:1–7. PMID: 21529740.

28. Lee KH, Jeong MH, Kim HM, Ahn Y, Kim JH, Chae SC, et al. KAMIR (Korea Acute Myocardial Infarction Registry) Investigators. Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol. J Am Coll Cardiol. 2011; 58:1664–1671. PMID: 21982310.

29. Sim DS, Jeong MH, Cho KH, Ahn Y, Kim YJ, Chae SC, et al. Other Korea Acute Myocardial Infarction Registry (KAMIR) Investigators. Effect of early statin treatment in patients with cardiogenic shock complicating acute myocardial infarction. Korean Circ J. 2013; 43:100–109. PMID: 23508129.

30. Jeong HC, Ahn Y, Hong YJ, Kim JH, Jeong MH, Kim YJ, et al. Other KAMIR (Korea Acute Myocardial Infarction Registry) Investigators. Statin therapy to reduce stent thrombosis in acute myocardial infarction patients with elevated high-sensitivity C-reactive protein. Int J Cardiol. 2012; [Epub ahead of print].

31. Dupuis J, Tardif JC, Cernacek P, Théroux P. Cholesterol reduction rapidly improves endothelial function after acute coronary syndromes. The RECIFE (reduction of cholesterol in ischemia and function of the endothelium) trial. Circulation. 1999; 99:3227–3233. PMID: 10385495.

32. Ridker PM, Rifai N, Pfeffer MA, Sacks FM, Moye LA, Goldman S, et al. Cholesterol and Recurrent Events (CARE) Investigators. Inflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Circulation. 1998; 98:839–844. PMID: 9738637.

33. Lefer DJ. Statins as potent antiinflammatory drugs. Circulation. 2002; 106:2041–2042. PMID: 12379569.

34. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, et al. JUPITER Study Group. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008; 359:2195–2207. PMID: 18997196.

35. Lacoste L, Lam JY, Hung J, Letchacovski G, Solymoss CB, Waters D. Hyperlipidemia and coronary disease. Correction of the increased thrombogenic potential with cholesterol reduction. Circulation. 1995; 92:3172–3177. PMID: 7586300.

36. Wanner C, Krane V, März W, Olschewski M, Mann JF, Ruf G, et al. German Diabetes and Dialysis Study Investigators. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med. 2005; 353:238–248. PMID: 16034009.

37. Krane V, Winkler K, Drechsler C, Lilienthal J, März W, Wanner C. German Diabetes and Dialysis Study Investigators. Effect of atorvastatin on inflammation and outcome in patients with type 2 diabetes mellitus on hemodialysis. Kidney Int. 2008; 74:1461–1467. PMID: 18818679.

38. Fellström BC, Jardine AG, Schmieder RE, Holdaas H, Bannister K, Beutler J, et al. AURORA Study Group. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med. 2009; 360:1395–1407. PMID: 19332456.

39. Baigent C, Landray MJ, Reith C, Emberson J, Wheeler DC, Tomson C, et al. SHARP Investigators. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet. 2011; 377:2181–2192. PMID: 21663949.

40. Lim SY, Bae EH, Choi JS, Kim CS, Park JW, Ma SK, et al. Korea Acute Myocardial Infarction Registry Investigators. Effect on short- and long-term major adverse cardiac events of statin treatment in patients with acute myocardial infarction and renal dysfunction. Am J Cardiol. 2012; 109:1425–1430. PMID: 22356794.

41. Graham DJ, Staffa JA, Shatin D, Andrade SE, Schech SD, La Grenade L, et al. Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs. JAMA. 2004; 292:2585–2590. PMID: 15572716.

42. Pasternak RC, Smith SC Jr, Bairey-Merz CN, Grundy SM, Cleeman JI, Lenfant C. American College of Cardiology. American Heart Association. National Heart, Lung and Blood Institute. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. Stroke. 2002; 33:2337–2341. PMID: 12215610.

43. Peto R, Emberson J, Landray M, Baigent C, Collins R, Clare R, et al. Analyses of cancer data from three ezetimibe trials. N Engl J Med. 2008; 359:1357–1366. PMID: 18765432.

44. Glynn RJ, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, et al. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. N Engl J Med. 2009; 360:1851–1861. PMID: 19329822.

45. Nielsen SF, Nordestgaard BG, Bojesen SE. Statin use and reduced cancer-related mortality. N Engl J Med. 2013; 368:576–577. PMID: 23388012.

46. Koh KK, Quon MJ, Han SH, Lee Y, Kim SJ, Shin EK. Atorvastatin causes insulin resistance and increases ambient glycemia in hypercholesterolemic patients. J Am Coll Cardiol. 2010; 55:1209–1216. PMID: 20298928.

47. Ishikawa M, Okajima F, Inoue N, Motomura K, Kato T, Takahashi A, et al. Distinct effects of pravastatin, atorvastatin, and simvastatin on insulin secretion from a beta-cell line, MIN6 cells. J Atheroscler Thromb. 2006; 13:329–335. PMID: 17192698.

48. Gannagé-Yared MH, Azar RR, Amm-Azar M, Khalifé S, Germanos-Haddad M, Neemtallah R, et al. Pravastatin does not affect insulin sensitivity and adipocytokines levels in healthy nondiabetic patients. Metabolism. 2005; 54:947–951. PMID: 15988706.

49. Kostapanos MS, Liamis GL, Milionis HJ, Elisaf MS. Do statins beneficially or adversely affect glucose homeostasis? Curr Vasc Pharmacol. 2010; 8:612–631. PMID: 20507274.

50. Baker WL, Talati R, White CM, Coleman CI. Differing effect of statins on insulin sensitivity in non-diabetics: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2010; 87:98–107. PMID: 19913318.