Curated by Peter Lansberg,
a Dutch lipidologist and educator, and
reviewed by prof. Philip Barter, Past President of the
International Atherosclerosis Society.
The IAS Statin Newsletter will keep you up-to-date with all recent statin publications, using a curated approach to select relevant articles.
Issue 5Statins started post AF related stroke shows mixed benefits
In this retrospective study using data from Taiwanese National Health Insurance Database, patients diagnosed between 2001 and 2011 with ischemic stroke and atrial fibrillation (AF) were selected. Patients (1 446) using statins in the first 90 days’ post stroke were matched with controls (3 092) not using statins. The primary and secondary endpoints were recurrent stroke and in-hospital death respectively.
After 0.3 – 12 year follow up (2.4 years median) follow up no difference was observed in stroke recurrence (HR 1.01, 95% CI 0.88 to 1.15; P=0.92; P<0.001). There were 324 patients (21.0%) with stroke recurrences in the statin group; 609 patients (19.7%) in the control group. No difference in stroke types or MACE. There was a robust decrease of deaths during any hospitalization over the 2.4 years’ median follow up; HR 0.74, 95% CI 0.61 to 0.89; P< 0.001). These were statistical significant for non-cardiovascular deaths only: 117 (7.6%) vs 310 (10%) p<0.001. Most of these were related to pulmonary infections, septicaemia and respiratory failure. The authors noted that possible explanations for the unexpected outcome were that statin exposure time and dosage were lower than in the large randomized clinical endpoint trial (SPARCL). Also, patients on statins had higher baseline cholesterol levels and only 52% continued statin therapy for longer than 1 year! The findings warrant more robust designed RCT’s to properly evaluate the impact of statins in AF related stroke patients.
Wu YL, Saver JL, Chen PC et al. Effect of statin use on clinical outcomes in ischemic stroke patients with atrial fibrillation. Medicine (Baltimore)
2017; 96:e5918. http://www.ncbi.nlm.nih.gov/pubmed/?term=28151869
Meta-analysis on the effects of fibrates and statins on Lp(a)
Extensive meta-analysis on Lp(a) lowering effects of statins and fibrates based on head-to-head comparison. Sixteen trials and 1388 subjects were evaluated. Fibrates were superior compared to statins in reducing Lp(a); bases on weighed mean difference (WMD): –2.70 mg/dL ( 95% CI, –4.56 to –0.84; P = 0.004). When statins + fibrates were compared to statin mono-therapy the WMD was –1.60 mg/dL (95% CI, –2.93 to –0.26; P = 0.019). There was no significant difference when compared to fibrate monotherapy; WMD: -1.75 mg/dl (95% CI, -5.44 to + 1.92; P=0.349). The authors concluded that Fibrates have a significantly greater effect in reducing plasma Lp(a) concentrations than statins. Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins.
Sahebkar A, Simental-Mendia LE, Watts GF et al. Comparison of the effects of fibrates versus statins on plasma lipoprotein(a) concentrations: a systematic review and meta-analysis of head-to-head randomized controlled trials. BMC Med
2017; 15:22. http://www.ncbi.nlm.nih.gov/pubmed/?term=28153024
Critical ill patients do better when treated with aspirin, beta-blockers or statins depending on baseline cardiac troponin levels
Patients admitted because of critical illnesses have a high mortality risk. Raised cardiac troponin (cTn) is a common finding in these patients, and observed in >60% of patients with sepsis alone. In this systematic review, the authors evaluated the impact of 3 drugs known to reduce cardiac mortality in patients with cTn elevations caused by AMI: aspirin, beta-blockers and statins. PubMed publications between 1976 and 19/2/2016 were included. In this review. Thirty-six articles were eventually included in the final analysis. CTn emerged as a marker of disease severity and associated with multi-organ failure and markedly increased risk of death. Statin were associated with immunomodulatory benefits in the early stages of diseases before multi organ failure develops. These patients were characterized by no or mildly elevated cTn levels. Aspirin and beta-blockers were associated with reduced mortality in the sickest patients with very high cTn plasma concentrations. Mitigation of platelet aggregation, microvascular obstruction and organ dysfunction were positively influenced through beta-blockers and aspirin. The authors concluded that cTn assessment could potentially guide appropriate medical management in critically ill patients. Properly designed prospective, observational studies need to re-confirm these findings.
Rothenberg FG, Clay MB, Jamali H, Vandivier-Pletsch RH. Systematic review of beta blocker, aspirin, and statin in critically ill patients: importance of severity of illness and cardiac troponin. Journal of investigative medicine : the official publication of the American Federation for Clinical Research
Primary prevention in isolated hypertension; statins, aspirin or both?
Retrospective observational analysis in hypertensive patients. Based on the Korean National Health Insurance Sample Cohort of 46 605 433 Koreans.The registry was initiated in 2002 and the cohort was followed for 11 years, until 2013. Patients with isolated hypertension were selected starting in 2005 and followed for 8 years. Of the 31 115 patients included, N=19 628 were not using statins or aspirin; N=4 814 aspirin only; N=4 717 statins only and N=1 956 used a combined treatment. The primary endpoint: al-cause and cardiovascular mortality from 2007-2013. Total mortality was reduced in patient using Aspirin only; HR 0.61 (95%CI 0.55-0.70; P< 0.001). Statins only: HR 0.48 (95%CI 0.41-0.57; P<0.001) and statin + aspirin combined: HR 0.66 (95%CI 0.34-0.55; P<0.001). Cardiovascular mortality was reduced as well; HR 0.66 (95%CI 0.53-0.85; P< 0.001); HR 0.46 (95%CI 0.33-0.64; P< 0.001) and HR 0.50 (95%CI 0.31-0.79; P= 0.003), respectively. The combination of statin + aspirin did not produce any additional benefit! The authors concluded, that aspirin and statins can reduce both all-cause and cardiovascular mortality in uncomplicated hypertensive patients. They do warn that aspirin administration is associated with an increased risk of major bleeding and care must be taken to assess the risk/benefit of using aspirin in individual patients.
Lee CJ, Oh J, Lee SH et al. Efficacy of aspirin and statins in primary prevention of cardiovascular mortality in uncomplicated hypertensive participants: a Korean national cohort study. J Hypertens
The challenge of prescribing statins: new onset diabetes
In this week publication two articles addressed the issue of new onset diabetes (NOD) in patients starting with (high dose) statins. In an Australian cohort of elderly women (76-82 years) followed for 10 years, the incidence of NOD was 5%. Overall the risk was calculated as HR 1.33 (95% CI 1.04-1.70; P=0.024) and equated to a number needed to harm (NNH) of 133 (95% CI 62-1079) for 5 years of statin exposure. Risk increased with higher statins dosage; HR 1.51 (95% CI 1.14-1.99). Careful monitoring in elderly women is advised.
The second paper is a comprehensive review summarizing data collected in observational studies, randomized trials, genetic and experimental/metabolic research. Glucose and HbA1C were not routinely measured in the older statin studies, this contributed to underreporting of NOD in clinical trials. Based on two recent meta-analyses of statin clinical trials, the risk for NOD increased by 9%-12%. This is sharp contrast with the increase of NOD in five population based studies by 18%-99%(!). Both secretion of insulin as well as insulin sensitivity are hampered in patients using statins and genetic studies implicated gene variants of genes targeted by LDL lowering drugs as well. Pravastatin was considered the least diabetogenic statin, while simvastatin, rosuvastatin and atorvastatin were the most diabetogenic. Despite the diabetogenic hazard, cardiovascular benefits still outweigh the risk diabetes, although in some populations, like the elderly women in the first publications careful evaluation and monitoring are warranted.
Jones M, Tett S, Peeters GM et al. New-Onset Diabetes After Statin Exposure in Elderly Women: The Australian Longitudinal Study on Women's Health. Drugs Aging
Laakso M, Kuusisto J. Diabetes Secondary to Treatment with Statins. Current diabetes reports
2017; 17:10. http://www.ncbi.nlm.nih.gov/pubmed/?term=28155189
Homozygous FH a therapeutic challenge
In this retrospective review, follow up time 38 years (21.2 ± 10 years), the long-term outcomes of 53 French homozygous FH patients (27males and 26 females) is portrayed. Some remarkable observations: 28 patients (53%) experienced a clinical event (CV death, non-fatal MI or angina) and 8 of the patients died. The mean age at a first event was 19 ± 8.2 years, the mean age at death 31.3 ± 1.4 years. Using a total cholesterol year score, cumulative lifelong exposure to cholesterol could be calculated. With a score of 100 mmol/L (= 10 years of average total cholesterol of 10 mmol/L or 5 years of 20 mmol/L) a doubling of risk for CV events was observed (Age adjusted incidence rate ratio: 1.99, 95% CI 1.16-3.41). total cholesterol was not significantly different between the patients that experienced and event compared to the ones that did not, but those that did showed a slower decline of total cholesterol over time. Total cholesterol in patients with receptor negative mutations was almost double (21.7 mmol/L) compared to patients with defective LDL-r mutations (12.5 mmol/L). Almost all patients, N=40, (75%) were treated LDL-apheresis plus with lipid lowering drugs. None of the patients reported muscle symptoms during statin treatment. Despite receiving maximal treatment, including weekly LDL-apheresis, progression of atherosclerosis, severe aortic calcifications, were observed in the 13 patients without events. The authors emphasize the need for earlier treatment initiation, using LDL-apheresis, and express hope that new therapeutic approaches such as MTP-inhibitors (Lometapide), ApoB antisense mRNA (Mipomersin) and PCSK9ab (Alirocumab/Evolocumab) will reduce the deleterious premature cardiovascular outcomes of these young patients.
Bruckert E, Kalmykova O, Bittar R et al. Long-term outcome in 53 patients with homozygous familial hypercholesterolaemia in a single centre in France. Atherosclerosis
2017; 257:130-137. http://www.ncbi.nlm.nih.gov/pubmed/?term=28131047
Statins safe for runners
Limited data is available on the effects that statins have on exercise related injuries. Musculoskeletal adverse effects are one of the major reasons for statin discontinuation and a healthy lifestyle, including regular physical exercise are pivotal for CVD prevention. In this observational Dutch study, using extensive on-line questionnaires to collect pertinent data, 4 460 amateur runners provide information on injuries that developed during exercise. Analysis was done in 3 separate cohorts; runners using statins, runners with hypercholesterolemia not using statins and controls. Despite the high prevalence of injuries (38%), higher incidence of trauma was observed when runners using statins were compared to controls. The crude odds ratios (ORs) for injuries, tendon or ligament-related injuries, and muscle-related injuries: HR 1.14 (95% CI 0.79-1,66); HR 1.10 (95% CI 0.71-1,72) and HR 1.15 (95% CI 0.69-1,91) respectively. Based on these observational findings, in a primary prevention setting, patients using statins are not at greater risk to develop injuries when regularly participating in strenuous sports like running
Bakker EA, Timmers S, Hopman MT et al. Association Between Statin Use and Prevalence of Exercise-Related Injuries: A Cross-Sectional Survey of Amateur Runners in the Netherlands. Sports medicine (Auckland, N.Z.)
Impact of statins after bariatric surgery
Single centre, retrospective analysis of 2878 patients who underwent bariatric surgery. Patients that had data recorded on statin use and diabetes status and that completed a 1 year follow up visit were included. Final sample size: 1575 patients. Procedures included laparoscopic
adjustable gastric banding (LAGB; n = 1035), Roux-en-Y gastric bypass (RYGB n = 468), and sleeve gastrectomy (SG; n = 72). No difference in new onset diabetes (NOD) could be determined, this was observed in 3 patients on preoperative statins vs. 4 of the patients that were not using statins. Patients using statins were more likely to have resolved their diabetes 159 (23.7%) vs. only 124 patients (13.7%) in the group not using statins. Despite observing more severe diabetes (requiring insulin) in the statin group. If patients stopped using statins, they were more likely to experience a diabetic remission, n = 85 (35.7%) than the ones that continued using their statins, n = 57 (17%). Statin use was also associated with a greater reduction in BMI and weight loss in RYGB, and in the diabetic patients. The authors concluded that the current findings are re-assuring regarding statin use in bariatric surgery patients, but that additional studies are detrimental to clarify the impact of statin therapy on weight loss, diabetes risk, insulin sensitivity, and metabolic health in patients with obesity
Taylor BA, Ng J, Stone A et al. Effects of statin therapy on weight loss and diabetes in bariatric patients. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
Pregnancy outcomes in women using statins
First large retrospective analysis of pregnancy loss experienced by women using statins just before or early in pregnancy compared to women who did not. Based on the UK General Practice Research Database and analysing pregnancies that occurred between 1/1/1992 and 31/3/2009. Using a case control approach 281 pregnancies of women potentially exposed to statins were matched with 2463 unexposed pregnancies. Successful deliveries were observed in 54.45% in women exposed to statins vs. 62.81% in the control group. Spontaneous abortions were observed in 25.7% and 20.81% respectively. Based on a time dependent exposure analysis the risk of spontaneous pregnancy loss, was calculated as a HR: 1.64 (95% CI 1.10-2.46). No increased incidence of major congenital malformations, in children exposed to statins during pregnancy, could be ascertained, but the number of pregnancies was most likely too small to observe significant difference of this outcome. The authors concluded that there is a need for better preparation of women that are prescribed statins and want to become pregnant.
McGrogan A, Snowball J, Charlton RA. Statins during pregnancy: a cohort study using the General Practice Research Database to investigate pregnancy loss. Pharmacoepidemiol Drug Saf
Atorvastatin 20 mg vs atorvastatin 10 mg + 10 ezetimibe in the very old (80 -90 years)
Very elderly patients post AMI should start statin treatment but face a higher risk of side effects. In this single centre study, 230 octogenarian Chinese patients were randomized to atorvastatin 10 mg/ezetimibe 10 mg (n=114) or Atorvastatin 20 mg (n=116) and followed for 1 year. The primary endpoints were major cardiovascular events MACE (cardiac death, MI and revascularization). LDL-c reduction after 1 year were not significantly different between the two cohorts; >50% and > 30% LDL-c lowering was observed in 54.6% vs 49.5% (p=0.45) and 93.4% vs 90.1% (p=0.36) in the Ator 10 + Eze 10 vs the ator 10 group respectively. MACE rates were similar as well: 23.2% vs. 19.8%, p=0.55; HR 1.12 (95% CI 0.51 -2.55) P=0.74. the only observed difference were the changes in ALT. Patients on Atorvastatin 20 mg experienced more frequently ALT rises > upper limit of normal; 9.0% vs 2.8% (P=0.05).
The authors concluded that in the very elderly combining ezetimibe 10 mg with atorvastatin 10 mg showed similar improvements in LDL-C reductions and major cardiovascular events. No differences in new onset diabetes and CK elevations were noted. The authors concluded that the combination of 10 mg atorvastatin with 10 mg ezetimibe proved to be an attractive alternative as compared to doubling the statin dose to 20 mg.
Liu Z, Hao H, Yin C et al. Therapeutic effects of atorvastatin and ezetimibe compared with double-dose atorvastatin in very elderly patients with acute coronary syndrome. Oncotarget
Koreans struggle with ACC/AHA guidelines on high intensity/high dose statins
Based on the 2013 ACC/AHA guidelines, patients at high risk and with a baseline LDL-C of 190 mg/dl or higher should be treated with high dose/high intensity statins. Extracting data from a single hospital a total of 33 721 patients were prescribed a statin between January 2009 and December 2013. Only 655 patients (1.9%) had an LDL-c > 190 mg/dl. Due to missing data only 179 patients were included in the study. High intensity statins were prescribed in 14 patients (7.8%). Mean baseline LDL-C: 5.08 ±0.8 mmol/L. Atorvastatin 40 mg reduced LDL-C by 47%; Rosuvastatin 20 mg., 58%. Atorvastatin 20 mg, Simvastatin 20-40 mg , Pitavastatin 4 mg and Rosuvastatin 10 mg achieved on average LDL-C reduction of approximately 50%. The groups were too small to reach statistical significance. The authors suggested that based on their findings in this study, that moderate intensity statins should be sufficient to establish similar LDL-C reductions in Koreans as high intensity statins in western Caucasian populations. They do acknowledge that a much larger randomized controlled trial is needed to provide more definite evidence to draw final conclusions on the statin type and statin dosage for high risk Korean patients.
Kim HS, Lee H, Lee SH et al. Use of Moderate-Intensity Statins for Low-Density Lipoprotein Cholesterol Level above 190 mg/dL at Baseline in Koreans. Basic & clinical pharmacology & toxicology
- Tecson KM, Panettiere-Kennedy KS, Won JI et al. Relation between proprotein convertase subtilisin/kexin type 9 and directly measured low-density lipoprotein cholesterol. Proceedings (Baylor University. Medical Center) 2017; 30:16-20. http://www.ncbi.nlm.nih.gov/pubmed/?term=28127122
- Standl E, Schnell O, McGuire DK et al. Integration of recent evidence into management of patients with atherosclerotic cardiovascular disease and type 2 diabetes. The lancet. Diabetes & endocrinology 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28131656
- Sirenko Y, Radchenko G. Impact of Statin Therapy on the Blood Pressure-Lowering Efficacy of a Single-Pill Perindopril/Amlodipine Combination in Hypertensive Patients with Hypercholesterolemia. High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension 2017; 24:85-93. http://www.ncbi.nlm.nih.gov/pubmed/?term=28150140
- Schmitz J, Gouni-Berthold I. Anti-PCSK9 antibodies: A new era in the treatment of dyslipidemia. Current pharmaceutical design 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28137217
- Panes O, Gonzalez C, Hidalgo P et al. Platelet tissue factor activity and membrane cholesterol are increased in hypercholesterolemia and normalized by rosuvastatin, but not by atorvastatin. Atherosclerosis 2016; 257:164-171. http://www.ncbi.nlm.nih.gov/pubmed/?term=28142075
- McKibben RA, Al Rifai M, Mathews LM, Michos ED. Primary Prevention of Atherosclerotic Cardiovascular Disease in Women. Current cardiovascular risk reports 2016; 10. http://www.ncbi.nlm.nih.gov/pubmed/?term=28149430
- Kishi T, Rider LG, Pak K et al. Anti-3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Autoantibodies are Associated with DRB1*07:01 and Severe Myositis in Pediatric Myositis Patients. Arthritis care & research 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28129483
- Ballotta E, Toniato A, Farina F, Baracchini C. Effects of preoperative statin use on perioperative outcomes of carotid endarterectomy. Brain and behavior 2017; 7:e00597. http://www.ncbi.nlm.nih.gov/pubmed/?term=28127515
- Vrablik M, Freiberger T, Blaha V, Ceska R. [Severe familial hypercholesterolemia treatment]. Vnitr Lek 2016; 62:895-901. http://www.ncbi.nlm.nih.gov/pubmed/?term=28128576
- Soska V. [Notes on the HOPE-3 study]. Vnitr Lek 2016; 62:929-932. http://www.ncbi.nlm.nih.gov/pubmed/?term=28128582
- Oscanoa Espinoza TJ, Paredes-Perez N, Lizaraso-Soto F. [Safety of statins]. Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) 2016; 73:263-278. http://www.ncbi.nlm.nih.gov/pubmed/?term=28152368
- Navarese EP, Gurbel PA, Andreotti F et al. Prevention of contrast-induced acute kidney injury in patients undergoing cardiovascular procedures-a systematic review and network meta-analysis. PLoS One 2017; 12:e0168726. http://www.ncbi.nlm.nih.gov/pubmed/?term=28151965
- Nakamura M, Fukukawa T, Kitagawa K et al. ANNALS EXPRESS: Ten-year standardization of lipids and high-sensitivity C-reactive protein in a randomized controlled trial to assess effects of statins on secondary stroke prevention: Japan Statin Treatment Against Recurrent Stroke (J-STARS). Annals of clinical biochemistry 2017:4563217693651. http://www.ncbi.nlm.nih.gov/pubmed/?term=28135841
- Morelli VM, Lijfering WM, Rosendaal FR, Cannegieter SC. Lipid levels and risk of recurrent venous thrombosis: results from the MEGA follow-up study. Journal of thrombosis and haemostasis : JTH 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28135040
- Mayor S. Single liver enzyme test in statin patients cuts full testing by a quarter, study finds. Bmj 2017; 356:j515. http://www.ncbi.nlm.nih.gov/pubmed/?term=28143852
- Liao WC, Huang MZ, Wang ML et al. Statin Decreases Helicobacter pylori Burden in Macrophages by Promoting Autophagy. Frontiers in cellular and infection microbiology 2016; 6:203. http://www.ncbi.nlm.nih.gov/pubmed/?term=28144585
- Liang Z, Li W, Liu J et al. Simvastatin suppresses the DNA replication licensing factor MCM7 and inhibits the growth of tamoxifen-resistant breast cancer cells. Scientific reports 2017; 7:41776. http://www.ncbi.nlm.nih.gov/pubmed/?term=28150753
- Koh KK. What Is the Best Disease-Guided Approach to Statin? J Am Coll Cardiol 2017; 69:600. http://www.ncbi.nlm.nih.gov/pubmed/?term=28153119
- Hung MS, Chen IC, Lee CP et al. Statin improves survival in patients with EGFR-TKI lung cancer: A nationwide population-based study. PLoS One 2017; 12:e0171137. http://www.ncbi.nlm.nih.gov/pubmed/?term=28158206
- Hoy SM. Pitavastatin: A Review in Hypercholesterolemia. Am J Cardiovasc Drugs 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28130659
- Homer K, Robson J, Solaiman S et al. Reducing liver function tests for statin monitoring: an observational comparison of two clinical commissioning groups. Br J Gen Pract 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28137784
- Hansen RA, Qian J, Berg R et al. Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs. Pharmacotherapy 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28152215
- Gulayin P, Irazola V, Lozada A et al. Educational intervention to improve effectiveness in treatment and control of patients with high cardiovascular risk in low-resource settings in Argentina: study protocol of a cluster randomised controlled trial. BMJ Open 2017; 7:e014420. http://www.ncbi.nlm.nih.gov/pubmed/?term=28143840
- Einarsen E, Cramariuc D, Lonnebakken MT et al. Comparison of Frequency of Ischemic Cardiovascular Events in Patients With Aortic Stenosis With Versus Without Asymmetric Septal Hypertrophy (from the SEAS Trial). Am J Cardiol 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28132685
- Broniarek I, Jarmuszkiewicz W. [Statins and mitochondria]. Postepy biochemii 2016; 62:77-84. http://www.ncbi.nlm.nih.gov/pubmed/?term=28132458
- Kim HS, Lee H, Lee SH et al. Use of Moderate-Intensity Statins for Low-Density Lipoprotein Cholesterol Level above 190 mg/dL at Baseline in Koreans. Basic & clinical pharmacology & toxicology 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28165667
- Mabuchi H. Half a Century Tales of Familial Hypercholesterolemia (FH) in Japan. J Atheroscler Thromb 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28179607
- Tseng MY, Czosnyka M, Pickard JD, Kirkpatrick PJ. Effects of Acute Treatment with Pravastatin on Cerebral Autoregulation in Patients after Aneurysmal Subarachnoid Hemorrhage 810. Neurosurgery 2006; 59:456. http://www.ncbi.nlm.nih.gov/pubmed/?term=28180674
- Hohenstein B. Lipoprotein(a) in nephrological patients. Clinical research in cardiology supplements 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28181057
- E D, E S, G D et al. Effect of ezetimibe on plasma adipokines: A Systematic review and meta-analysis. Br J Clin Pharmacol 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28166606
- Chhatriwalla AK, Rader DJ. Intracoronary Imaging, Reverse Cholesterol Transport, and Transcriptomics: Precision Medicine in CAD? J Am Coll Cardiol 2017; 69:641-643. http://www.ncbi.nlm.nih.gov/pubmed/?term=28183507
- Sana T, Aslam B, Aslam N et al. Therapeutic effect of atorvastatin on kidney functions and urinary excretion of Glimepiride in healthy adult human male subjects. Pak J Pharm Sci 2016; 29:2321-2326. http://www.ncbi.nlm.nih.gov/pubmed/?term=28167473
- Lee JB, Kim GS, Cho HN. Statin and Ezetimibe Combination Therapy Decreases Mean Platelet Volume Compared to Statin Monotherapy. J Stroke 2017; 19:109-110. http://www.ncbi.nlm.nih.gov/pubmed/?term=28178405
- Kishta SS, Kishta SA, El-Shenawy R. Statin (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor)-based therapy for hepatitis C virus (HCV) infection-related diseases in the era of direct-acting antiviral agents. F1000Research 2016; 5:223. http://www.ncbi.nlm.nih.gov/pubmed/?term=27583130
- Prajapati SK, Garabadu D, Krishnamurthy S. Coenzyme Q10 Prevents Mitochondrial Dysfunction and Facilitates Pharmacological Activity of Atorvastatin in 6-OHDA Induced Dopaminergic Toxicity in Rats. Neurotox Res 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28130746
- Liu PC, Lu G, Deng Y et al. Inhibition of NF-kappaB Pathway and Modulation of MAPK Signaling Pathways in Glioblastoma and Implications for Lovastatin and Tumor Necrosis Factor-Related Apoptosis Inducing Ligand (TRAIL) Combination Therapy. PLoS One 2017; 12:e0171157. http://www.ncbi.nlm.nih.gov/pubmed/?term=28135339
- Kang SY, Lee SB, Kim HJ et al. Autophagic modulation by rosuvastatin prevents rotenone-induced neurotoxicity in an in vitro model of Parkinson's disease. Neurosci Lett 2017; 642:20-26. http://www.ncbi.nlm.nih.gov/pubmed/?term=28137648
- Hirooka S, Ueno M, Fukuda S et al. Effects of Simvastatin on Alveolar Regeneration and Its Relationship to Exposure in Mice with Dexamethasone-Induced Emphysema. Biological & pharmaceutical bulletin 2017; 40:155-160. http://www.ncbi.nlm.nih.gov/pubmed/?term=28154254
- Han W, Li J, Tang H, Sun L. Treatment of obese asthma in a mouse model by simvastatin is associated with improving dyslipidemia and decreasing leptin level. Biochem Biophys Res Commun 2017; 484:396-402. http://www.ncbi.nlm.nih.gov/pubmed/?term=28131832
- Brinjikji W, Cloft H, Cekirge S et al. Lack of Association between Statin Use and Angiographic and Clinical Outcomes after Pipeline Embolization for Intracranial Aneurysms. AJNR. American journal of neuroradiology 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28154128
- Riekes MK, Dereymaker A, Berben P et al. Development of enteric-coated fixed dose combinations of amorphous solid dispersions of ezetimibe and lovastatin: Investigation of formulation and process parameters. Int J Pharm 2017; 520:49-58. http://www.ncbi.nlm.nih.gov/pubmed/?term=28153650
- Lai SW, Liao KF, Lin CL et al. Statins use and female lung cancer risk in Taiwan. The Libyan journal of medicine 2012; 7:20123. http://www.ncbi.nlm.nih.gov/pubmed/?term=28136089
- Khanfar M, Al-Nimry S. Stabilization and Amorphization of Lovastatin Using Different Types of Silica. AAPS PharmSciTech 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28127721
- Andrade-Pavon D, Cuevas-Hernandez RI, Trujillo-Ferrara JG et al. Recombinant 3-Hydroxy 3-Methyl Glutaryl-CoA Reductase from Candida glabrata (Rec-CgHMGR) Obtained by Heterologous Expression, as a Novel Therapeutic Target Model for Testing Synthetic Drugs. Appl Biochem Biotechnol 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28138930
- Ahsan MN, Prasad Verma PR. Solidified self nano-emulsifying drug delivery system of rosuvastatin calcium to treat diet-induced hyperlipidemia in rat: in vitro and in vivo evaluations. Therapeutic delivery 2017; 8:125-136. http://www.ncbi.nlm.nih.gov/pubmed/?term=28145826
- Wei L, Chen JS, Lin HT et al. Atorvastatin from target screening attenuates endothelial cell tube formation and migration by regulating urokinase receptor-related signaling pathway and F/G actin. Journal of the Chinese Medical Association : JCMA 2017; 80:86-95. http://www.ncbi.nlm.nih.gov/pubmed/?term=28159489
- Oliveira KA, Dal-Cim T, Lopes FG et al. Atorvastatin Promotes Cytotoxicity and Reduces Migration and Proliferation of Human A172 Glioma Cells. Mol Neurobiol 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28181188
- Mahmood A, Goussev A, Kazmi H et al. Simvastatin Provides Long-Lasting Benefits after Traumatic Brain Injury in Rats: 937. Neurosurgery 2009; 65:413. http://www.ncbi.nlm.nih.gov/pubmed/?term=28173370
- Ma H, Liang WJ, Shan MR et al. Pravastatin activates activator protein 2 alpha to argument the angiotensin II-induced abdominal aortic aneurysms. Oncotarget 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28179583
- Fraunberger P, Grone E, Grone HJ et al. Ezetimibe reduces cholesterol content and NF-kappaB activation in liver but not in intestinal tissue in guinea pigs. Journal of inflammation (London, England) 2017; 14:3. http://www.ncbi.nlm.nih.gov/pubmed/?term=28167864
- Coban N, Gulec C, Ozsait Selcuk B, Erginel-Unaltuna N. Role of simvastatin and RORalpha activity in the macrophage apoptotic pathway. Anatol J Cardiol 2017. http://www.ncbi.nlm.nih.gov/pubmed/?term=28179616
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