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Die „Non-Lipid-Effekte“ der Statine: Mythos oder Faktum?

The „non-lipid effects“ of statins: Fact or fiction?

  • Themenschwerpunkt „Statintherapie“
  • Published:
Wiener Medizinische Wochenschrift Aims and scope Submit manuscript

Zusammenfassung

Hydroxy-methylglutaryl-Coenzym-A-Reduktase-Inhibitoren (Statine) stellen derzeit die effektivste Methode zur pharmakologischen Senkung des totalen Plasmacholesterins dar. Große multizentrisch durchgeführte Studien konnten zeigen, dass durch die Gabe von Statinen über mehrere Jahre die kardiovaskuläre Morbidität und Mortalität signifikant gegenüber Plazebos gesenkt werden. Neben der bekannten LDL- und Gesamtcholesterin-senkenden Wirkung der Statine wurden auch sogenannte „Non-Lipid-Effekte“ postuliert, welche einen günstigen Einfluss auf die Gesamtmortalität ausüben sollen. Experimentelle Untersuchungen gaben deutliche Hinweise, dass Statine die Endothelzellfunktion verbessern, antiinflammatorisch und antioxidativ wirken, die arteriosklerotische Plaque stabilisieren und die Proliferation sowie die Aktivierung von glatten Muskelzellen hemmen. Die klinische Bedeutung dieser „Non-Lipid-Effekte“ konnte allerdings bis heute nicht eindeutig geklärt werden. Sie dürften aber im Vergleich zur cholesterinsenkenden Wirkung der Statine eine untergeordnete Rolle spielen.

Summary

Hydroxy-methylglutaryl coenzym A reductase-inhibitors (HMG-CoA [statins]) are currently the most effective method to pharmacologically decrease total plasma cholesterol levels. A number of multicenter studies have demonstrated, that statins administered for several years lead to a significant reduction of cardiovascular events and mortality compared with placebo. Apart from the well known LDL- and cholesterol lowering effect, statins have been postulated to exert benefical effects on mortality due to so called ‘non-lipid effects’. There is circumstantial evidence from a number of experimental studies that statins can improve endothelial function, exert anti-inflammatory and anti-oxidative effects, stabilize arteriosclerotic plaque and inhibit proliferation and activation of smooth muscle cells. However, the clinical implications of these benefical ‘non-lipid effects’ are unclear, but appear to exert only a minor role in comparison to the lowering effect of statins on total plasma cholesterol levels.

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Authors and Affiliations

  1. Universitätsklinik für Klinische Pharmakologie, Universität Wien, Währinger Gürtel 18-20, A-1090, Wien

    Eleonora Urbauer & Christian Joukhadar

  2. Universitätsklinik für Innere Medizin I, Wien

    Eleonora Urbauer

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  1. Eleonora Urbauer
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  2. Christian Joukhadar
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Correspondence to Christian Joukhadar.

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Urbauer, E., Joukhadar, C. Die „Non-Lipid-Effekte“ der Statine: Mythos oder Faktum?. WMW 153, 244–249 (2003). https://doi.org/10.1046/j.1563-258X.2003.03028.x

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  • DOI: https://doi.org/10.1046/j.1563-258X.2003.03028.x

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