Different approaches to statins
In the dyslipidemia management LDL-C as a main target of the theraphy was accepted more than a decade. Statins accepted as the corner stones of the therapy are able to decrease LDL-C by a range of approximately 30-50% depending on their potency and dose of the statin administered, their usage are still lower in the clinical practice by physicians. It is still a question for clinicians that if more intensive lowering of LDL-C provides additional cardiovascular benefit or not. Intensive lowering of LDL-C as it pertains to the incidence of cardiovascular outcomes (including myocardial infarction, coronary revascularization and ischemic stroke) is assessed in randomized controlled trials. JUPITER, an acronym for Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin, tested the hypothesis that statin treatment may reduce vascular events in persons with elevated highsensitivity C-reactive protein (CRP) but without hyperlipidemia. JUPITER trial focusing on hsCRP has shown that inflammation is a key player for cardiovascular disease independent of cholesterol levels. In the Heart Protection Study it was shown that statins are safe treatment options and effective as cardioprotective therapy. Such findings are the subject of other studies. Although statin treatment has beneficial effects possibility of some side effects like the development of new diabetes mellitus is still confusing. Another important key point for statin treatment is the withdrawal of statins. A considerable proportion of patients with acute ischemic stroke are at increased risk of death within the first year after the index event because they discontinue statin therapy, often without a specific medical reason. Same risks were persistant with the other patient groups who experienced cardiovascular events. Although there are some discussions about statin use, it seems useful and beneficial for the patients at increased risk of cardiovascular events.
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