Statin effects beyond lipid lowering—are they clinically relevant?

3.6 Conclusion

Today, there is growing evidence that statins are more than simple lipid-lowering drugs. In recent years a large number of experimental studies confirmed that these compounds exert several potentially beneficial effects by mechanisms unrelated to changes of cholesterol metabolism. In addition, recent evidence suggests that at least some of these effects might also play a role in humans particularly in specific situations, such as acute coronary syndromes. However, we still know very little about the clinical relevance of these lipid-independent statin properties, which is mainly due to the difficulty of differentiating them from thoserelated to modification of plasma cholesterol levels in vivo. In addition, it should be kept in mind that some of the lipid-independent effects found inexperimental studies could also be harmful inhumans. Thus, it is too early to advocate the useof statins in patients with normal cholesterollevels based on their pleiotropic lipid-independent effects. However, the huge amount of experimental data in favor of such effects cannotbe denied and should stimulate the initiation of further studies to clarify their clinical significance.