Statins and inflammation: an update

Abstract

Purpose of review: Randomized trials have suggested that the beneficial effects of statins could extend to mechanisms beyond cholesterol reduction. Investigations have shown that statins are associated with reduced plasma markers of inflammation, reduced T-cell and monocyte activation, and reduced blood clotting. These effects could be explained by the inhibition of L-mevalonic acid synthesis, thus affecting cell-signalling pathways. However, it has been difficult to evaluate whether the nonlipid effects of statins translate into clinically meaningful outcomes.

Recent findings: Inflammation, as measured by C-reactive protein (CRP), has been established as an independent cardiovascular risk factor, even in persons with low-density lipoprotein (LDL)-cholesterol. Statins have anti-inflammatory effects, and lower CRP. Reducing both LDL-cholesterol and CRP is important in order to decrease the risk of cardiovascular events. Statins significantly reduce the risk of venous thrombosis. It is probable that this effect goes beyond lipid lowering. The clinical benefit of statin therapy in infectious diseases remains to be determined by randomized controlled trials.

Summary: Statins have anti-inflammatory properties that are clinically important in lowering cardiovascular risk. It is probable, but not definitely proven, that some of the benefits of statins are due to their nonlipid effects.