Beyond Lipid-Lowering: Effects of Statins on Cardiovascular and Cerebrovascular Diseases and Cancer

Abstract

The 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, also known as statins, are administered as first-line therapy for hypercholesterolemia, both as primary and secondary prevention. Besides the lipid-lowering effect, statins have been suggested to inhibit the development of cardiovascular disease through anti-inflammatory, antioxidant, vascular endothelial function-improving, plaque-stabilizing, and platelet aggregation-inhibiting effects. The preventive effect of statins on atherothrombotic stroke has been well established, but statins can influence other cerebrovascular diseases. This suggests that statins have many neuroprotective effects in addition to lowering cholesterol. Furthermore, research suggests that statins cause pro-apoptotic, growth-inhibitory, and pro-differentiation effects in various malignancies. Preclinical and clinical evidence suggests that statins inhibit tumor growth and induce apoptosis in specific cancer cell types. The pleiotropic effects of statins on cardiovascular and cerebrovascular diseases have been well established; however, the effects of statins on cancer patients have not been fully elucidated and are still controversial. This review discusses the recent evidence on the effects of statins on cardiovascular and cerebrovascular diseases and cancer. Additionally, this study describes the pharmacological action of statins, focusing on the aspect of ‘beyond lipid-lowering’.

Statins on Spontaneous Intracerebral Hemorrhage: A Meta-Analysis

“…Because statins can lower blood lipids well, they play an important role in ischemic heart and cerebrovascular diseases based on antiatherosclerosis, which is also inseparable from the wide range of applications of statins [ 7 ]. Therefore, statins are widely used in the primary and secondary prevention of cardiovascular and cerebrovascular diseases [ 8 ]. In recent years, some animal experiments and basic studies have shown that statins can improve the prognosis of cerebral hemorrhage.…”

Non-Lipid Effects of PCSK9 Monoclonal Antibodies on Vessel Wall

“…As a result, in presence of PSCK9 antibodies, platelet-dependent thrombus formations significantly reduced [68]. Many studies indicate that statins [69] and PCSK9 monoclonal antibodies [70] have an effect on the hemostatic system. In approximately a third of patients, platelets show suboptimal response to antithrombotic therapy that can be linked to hypercholesterolemia [71].…”

Benefits and limitations of statin use in primary cardiovascular prevention: recent advances

“…6 In contrast, statins may even have beneficial effect in some cancers but this is not established. 50 Hemorrhagic stroke While statin treatment reduces the risk of ischemic stroke, there has been much controversy about their relationship with intracerebral hemorrhage. 6, 51 In any case, the risk is probably minor, although caution may be indicated with lobar intracerebral hemorrhage related to cerebral amyloid angiopathy.…”