Published online before print September 22, 2005, doi: 10.1161/01.STR.0000185931.20915.6f
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(Stroke. 2005;36:2058.)
© 2005 American Heart Association, Inc.
Editorials |
Improved Perioperative Outcomes From Carotid Endarterectomy
Yet Another Statin Side Effect?
From the Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Boston, Mass.
Correspondence to David M. Kent, MD, MS, Institute for Clinical Research and Health Policy Studies, Tufts-New England Medical Center, 750 Washington St, Box 63, Boston, MA 02138. E-mail dkent1@tufts-nemc.org
Key Words: carotid endarterectomy • treatment outcome
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
A cardiologist colleague at our hospital jokes that he prefers to prescribe medicines when they are first marketed because they have fewer side effects. As a rule, much remains unknown about the unintended effects of pharmaceutical agents at the time of an initial drug launch, and with some regularity, these side consequences yield black box warnings, product recalls, and even congressional hearings.1 The rule of unintended effects applies also to statins; with each passing month, it seems the literature has several new reports about the unexpected effects of these agents. However, with paradoxical and almost miraculous consistency, the side consequences of statins are health promoting and life prolonging. Through a variety of biochemical pathways, statins exert pleiotropic physiological effects,2,3 in addition to their lipid-lowering effects, which include improving endothelial dysfunction, enhancing atherosclerotic plaque stability, increasing NO bioavailability, decreasing oxidative stress, blunting the inflammatory response, increasing bone mineral density, and inhibiting thrombogenesis. These physiological effects are believed to have potential benefit for a wide variety of disorders, including (but not limited to) preventing Alzheimer disease, slowing progression of chronic kidney disease, treating osteoporosis and rheumatic diseases, preventing type 2 diabetes, preventing prostate and colon cancer, and even reducing mortality in pneumonia and sepsis.4,5 These putative effects are so varied and salubrious that readers (of a certain generation) may think of statins as the pharmaceutical equivalent of "Shimmer," the versatile if fictitious household product from the spoof advertisement on Saturday Night Live: "It’s a floor wax AND a dessert topping!"
In
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Stroke 2005 36: 2072-2076.