Considering that some works have shown CRP as an independent risk factor of CV and that statins could reduce CRP levels and prevent CV events, our findings show that some people that might benefit from the pleiotropic effect of statin remain without treatment if the decision is based only in those classical risk factors present in FRS.
RESUMOA aterosclerose é resultado da associação de uma deposição de lipí-dios na parede arterial e um processo inflamatório de baixo grau. Essa inflamação pode ser detectada através da dosagem de marcadores séricos, que indicam o grau de aterosclerose, e estão associados a um maior risco de desenvolvimento de doenças cardiovasculares, independentemente dos níveis lipídicos. Entre estes marcadores destacase a Proteína C reativa ultra-sensível. As estatinas reduzem a inflamação associada à aterosclerose, o que é verificado por uma redução dos valores de proteína C reativa. Parte desse efeito está associada à diminuição de proteínas isopreniladas, porém as estatinas possuem efeitos diretos no sistema imune. Variações genéticas individuais estão associadas a variações no efeito hipolipemiante das estatinas, porém pouco se sabe sobre as variantes que interferem com as ações antiinflamatórias desses medicamentos. Além dos genes envolvidos no metabolismo do colesterol, genes que influenciam a farmacocinéti-ca e a farmacodinâmica das estatinas são possíveis responsáveis pela variação do efeito antiinflamatório observado. Atherosclerosis is a result from the association of lipid deposition in the arterial wall and inflammatory process. This inflammatory process may be detected by clinical markers of systemic inflammation, such as ultrasensible C-reactive protein, which is associated with cardiovascular risk, independently of lipid levels. Statins reduce the inflammation associated to atherosclerosis, which may be verified by a reduction of the C-reactive protein levels. It seems that statins alter immune function by modulating post-translational protein prenylation. Individual genetic variations are associated with modulation of statins lipid-lowering effect; however, few studies have related the effect of the genetic variants with anti-inflammatory effect of statins. In addition to the genes involved in the cholesterol metabolism, genetic factors affecting statins pharmacodynamics and/or pharmacokinetics are potentially responsible for lipid and anti-inflammatory effects.
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