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Statins

Statins are lipid-lowering drugs used in patients with high cholesterol, both pre-and post- MI.

Uses

hyperlipidemia
In patients with coronary heart disease and metabolic syndrome, at 5 year follow-up major cardiac events were less common in patients receiving atorvastatin 80 mg (9.5%) than those receiving atorvastatin 10 mg (13%) (hazard ratio 0·71; 95% CI 0·61–0·84; p<0·0001) Lancet, 2006
A primary event occurred in 8.7% of patients receiving 80 mg of atorvastatin, as compared with 10.9% receiving 10 mg of atorvastatin, representing an absolute reduction in the rate of major cardiovascular events of 2.2 percent and a 22 percent relative reduction in risk (hazard ratio, 0.78; 95 percent confidence interval, 0.69 to 0.89; P<0.001). There was no difference between the two treatment groups in overall mortality. NEJM, 2005
also appear to have an effect on inflammation

Mechanism

statins reduce hepatic cholesterol synthesis, lower intrcellular cholesterol, stimulate LDL uptake. The net effect is to decrease LDL levels in the blood.
Decreases oxidative stress; leads to plaque stability

Dose and Half Life

Doubling a dose of statins decreases the LDL by 6%.

Side Effects

short term

constipation
dyspepsia
farting

long term

muscle breakdown; acute renal failure; serum creatine phosphokinase (CPK) measures rhabdomyolysis and should be done 6 weeks following the start
liver failure

Counter-Indications

Metabolism and Excretion

Dependency