Hydroxymethylglutaryl-CoA reductase inhibitors (statins) for the treatment of sepsis in adults – A systematic review and meta-analysis

Objectives

The pleiotropic effect of hydroxymethylglutaryl-CoA reductase inhibitors (statins) might have a beneficial effect in sepsis through several mechanisms. The aim was to assess the efficacy and safety of statins, compared with placebo, for the treatment of sepsis in adults.

Pharmacodynamic relationship between PCSK9, alirocumab,and LDL-C lowering in the ODYSSEY CHOICE I trial

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强化他汀与联合调脂:降脂幅度相同,获益却不同

本文论述了强化他汀与联合调脂在降脂效应、临床获益和安全性之间的差别,指出强化他汀不同于联合调脂;其次强调强化他汀在概念上不同于强化降脂,临床实践中强化他汀的提法更为适合。     

普伐他汀、福辛普利及合用对大鼠心肌梗死后肿瘤坏死因子-α表达及心室重构的影响

目的探讨普伐他汀、福辛普利及合用对大鼠心肌梗死后心室重构、心功能、肿瘤坏死因子α(TNFα)表达、基质金属蛋白酶(MMPs)活性等的影响。方法通过结扎冠状动脉前降支诱导大鼠急性心肌梗死(AMI),AMI后24h存活的48只大鼠随机分为AMI组,福辛普利组(10mg·kg1·d1),普伐他汀组(20mg·kg1·d1),普伐他汀(20mg·kg1·d1)加福辛普利组(10mg·kg1·d1),每组12只。另设假手术组(n=8)。术后24h开始直接灌胃给药,AMI及假手术组大鼠灌等量生理盐水。用药42天后,测定心功能和血流动力学参数,以反转录聚合酶链反应检测心肌TNFαmRNA的表达,酶谱法测定左室心肌MMPs活性,并测定心室重量/体重。结果梗死面积在AMI及各治疗组间差异均无统计学意义。与AMI组比较,福辛普利、普伐他汀、联合用药均使AMI组增加的左室舒张末压、左室舒张末直径、左室相对重量下降(P<0.05～0.01),使下降的左室压最大上升速率和下降速率、左室短轴缩短率、射血分数不同程度增加(P<0.05～0.01)。福辛普利、普伐他汀、联合用药分别使AMI组表达增加的TNFα降低29%、26%、33%(P<0.01);使MMP2活性水平降低25%、30%、35%(P<0.01);使MMP9活性水平降低20%、18%、24%(P<0.01)。联合用药较单用福辛普利或普伐他汀,对射血分数、左室短轴缩短率、左室压最大上     

Simvastatin reduces plasma concentration of high-sensitivity C-reactive protein in type 2 diabetic patients with hyperlipidemia

High-sensitivity C-reactive protein (hs-CRP) is positively associated with the prevalence of coronary artery disease by epidemiologic data. Prospective studies indicate that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors reduced the plasma hs-CRP concentration and the risk of recurrent coronary events after myocardial infarction. Type 2 diabetes is associated with high mortality risk of coronary heart disease and this high risk may be involved in the inflammatory factors. We have therefore conducted a prospective study to assess whether simvastatin can rapidly reduce the plasma hs-CRP concentration in type 2 diabetic patients with hyperlipidemia. Seventeen type 2 diabetic patients with hyperlipidemia were enrolled in the study after 6 weeks on a lipid-lowering diet. Fourteen patients completed the study, taking simvastatin 20 mg daily for 8 weeks. Fasting blood samples were collected from each patient before and after 8-week administration of simvastatin. In response to 8-week administration of simvastatin, hs-CRP levels significantly decreased from 0.312±0.057 to 0.193±0.045 mg/dl (P<.01). Plasma LDL cholesterol also decreased significantly from 130±9 to 74±3 mg/dl (P=.001). This study shows that plasma hs-CRP concentration can be reduced by 8-week administration of simvastatin in type 2 diabetic patients with hyperlipidemia.     

Changes of Lipid Profile and C-Reactive Protein after Withdrawal of Xuezhikang,an Extract of Cholestin,in Patients With Stable Angina Pectoris

Lipid-lowering therapy using HMG-CoA reductase inhibitors (statins) has been shown to assist in the prevention of cardiovascular events in many clinical trials[1-3]. Statins may also have an abundance of pleiotropic effects[4-7]. C-reactive protein (CRP),…     

Association between statin use and cognitive function: A systematic review of randomized clinical trials and observational studies

The US Food and Drug Administration issued a black box warning in 2012 regarding the association of statin use with cognitive impairment. This may deter patients and practitioners from using statins for guideline-directed indications. Large studies have not shown an increase in cognitive impairment with statin use. MEDLINE, EMBASE, and Cochrane databases were searched up to October 2019. We present an up-to-date systematic review of randomized controlled trials (RCTs) and prospective observational studies examining the association between statin use and cognitive status in a population aged ≥60 years. Twenty-four studies with 1,404,459 participants were included in the review. Twenty-one were prospective observational studies, and 3 were RCTs. All 3 RCTs, which ranged from 3.2 to 5.6 years of follow-up, showed no significant association between statin use and adverse cognitive effects (odds ratio [OR] 1.03 [0.82–1.30]) and (OR 1.0 [0.61–1.65]). The mean difference in the Mini-Mental State Examination was insignificant (0.06 [?0.04 to 0.16]) in the third RCT. The follow-up for observational studies ranged from 3 to 15 years. Ten observational studies showed reduced incidence of dementia. Seven showed no association with incident dementia. Three studies showed decline in cognition was similar, whereas one showed slower decline with statin use. There was no evidence of adverse cognitive effects, including incidence of dementia, deterioration in global cognition, or specific cognitive domains associated with statin use in individuals aged ≥60 years. Future studies should examine this association in studies with longer follow-up periods.