Author + information
- Leo Marcoff, MD and
- Paul D. Thompson, MD, FACC⁎ ()
- ↵⁎Hartford Hospital, Cardiology, 80 Seymour Street, P.O. Box 5037, Hartford, Connecticut 06102-8000
Dr. Wolinsky raises an interesting issue. Statins block the rate-limiting enzyme in the mevalonate pathway reducing cholesterol production, but also reduce production of farnesyl and geranylgeranyl pyrophosphate. These molecules participate in post-translational modification or prenylation of the Ras superfamily guanosine triphosphatases or small G proteins. Small G proteins are involved in cell signaling and proliferation. Statin inhibition of these G proteins decreases vascular smooth muscle hypertrophy and proliferation, improves endothelial function, and reduces angiotensin I receptor expression (1). It may also explain the statin antiarrhythmic effect in atrial fibrillation (2).
Coenzyme Q10 (Q10) supplementation should not affect small G protein production since Q10 is not involved in the G protein prenylation process. Furthermore, we recommended that Q10 supplementation be “tested” or “trialed” (3) only in statin myalgic patients to allow ongoing statin treatment.
- American College of Cardiology Foundation