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European Heart Journal Advance Access originally published online on January 22, 2007
European Heart Journal 2007 28(6):664-672; doi:10.1093/eurheartj/ehl445
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

A review of high-dose statin therapy: targeting cholesterol and inflammation in atherosclerosis

Taral N. Patel, Mehdi H. Shishehbor and Deepak L. Bhatt*

Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Desk F25, Cleveland, OH 44195, USA

Received 18 July 2006; revised 21 November 2006; accepted 30 November 2006; online publish-ahead-of-print 22 January 2007.

* Corresponding author. Tel: +1 216 445 4042; fax: +1 216 445 8531. E-mail address: bhattd{at}ccf.org

Lipid lowering with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors or ‘statins’ has dramatically reduced morbidity and mortality in patients with established cardiovascular disease. Recently, there have been multiple studies investigating the role of high-dose statin therapy with more aggressive lipid lowering in this setting. Concomitantly, there is increasing evidence implicating a role of inflammation in the pathogenesis of atherosclerosis. These high-dose statin trials and other studies have also provided a wealth of data suggesting that statins have anti-inflammatory and anti-oxidant properties that go beyond their lipid-lowering effects. In this review, we will provide a brief overview of recent, large-scale, randomized, placebo and active controlled trials of high-dose statin therapy in the setting of stable and unstable coronary artery disease and percutaneous coronary intervention. Further, we will discuss the evidence for effects of high-dose statin therapy on inflammation and C-reactive protein.

Key Words: Coronary artery disease • 3-hydroxy 3-methylglutaryl CoA reductase inhibitors (statins) • C-reactive protein • LDL


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