Author + information
- Received November 4, 2013
- Revision received January 10, 2014
- Accepted January 29, 2014
- Published online June 17, 2014.
- Dimitris Tousoulis, MD, PhD∗∗ (, )
- Costas Psarros, MSc∗,
- Michael Demosthenous, MD∗,
- Rikhil Patel, MD†,
- Charalambos Antoniades, MD, PhD∗,† and
- Christodoulos Stefanadis, MD∗
- ∗First Cardiology Department, Athens University Medical School, Athens, Greece
- †Radcliffe Department of Medicine, Cardiovascular Medicine Division, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- ↵∗Reprint requests and correspondence:
Prof. Dimitris Tousoulis, First Cardiology Department, Athens University Medical School, Hippokration Hospital, Vasilissis Sofias 114, Athens Attiki 153 44, Greece.
Atherosclerosis, the main pathophysiological condition leading to cardiovascular disease (CVD), is now considered to be a chronic inflammatory condition. Statins are the most widely used and promising agents in treating CVD and are renowned for their pleiotropic lipid-lowering independent effects. Statins exert their anti-inflammatory effects on the vascular wall through a variety of molecular pathways of the innate and adaptive immune systems, their impact on the circulating levels of pro-inflammatory cytokines, and their effect on adhesion molecules. By inhibiting the mevalonate pathway and isoprenoid formation, statins account for the increase of nitric oxide bioavailability and the improvement of vascular and myocardial redox state by multiple different mechanisms (directly or indirectly through low-density lipoprotein [LDL] lowering). A large number of randomized control trials have shown that statins help in the primary and secondary prevention of cardiovascular events, not only via their lipid-lowering effect, but also due to their anti-inflammatory potential as well. In this paper, we examine the molecular pathways in which statins are implicated and exert their anti-inflammatory effects, and we focus specifically on their impact on innate and adaptive immunity systems. Finally, we review the most important clinical data for the role of statins in primary and secondary prevention of cardiovascular events.
This study was supported by the Hellenic Cardiological Society. All authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Tousoulis and Psarros contributed equally to this work and should be considered joint first authors.
- Received November 4, 2013.
- Revision received January 10, 2014.
- Accepted January 29, 2014.
- 2014 American College of Cardiology Foundation
- Role of Redox-Sensitive Transcriptional Pathways: Nuclear Factor-kappa B and Activator Protein-1
- Pro-Inflammatory Cytokines and Adhesion Molecules in Atherosclerosis
- Innate and Adaptive Immunity in Atherosclerosis
- Targeting Inflammation for the Treatment of Atherosclerosis
- Statins and Their Anti-Inflammatory Effects: General Role of Statins in Inflammation
- Effect of Statins on Primary and Secondary Prevention of Cardiovascular Events
- Impact of Statins on Redox-Sensitive Transcriptional Pathways
- Effect of Statins on Innate Immune Responses
- Effects of Statins on Adaptive Immunity System
- Effect of Statins on Circulating Pro-Inflammatory Cytokines
- Effect of Statins on Adhesion Molecules
- Statin Effects on Coenzyme Q10