Statins

Uses

• Incidence in USA: Estimated 20 million

• Primary indications include:

  • Hyperlipidemia: HMG-CoA reductase inhibitors (statins) are powerful drugs for lowering LDL cholesterol concentrations, and certain statins—atorvastatin in high doses and rosuvastatin—increase concentrations of healthy HDL cholesterol.

  • Primary and secondary prevention of CV disease: CV benefits (reduction in myocardial infarction and stroke) in pts with hypercholesterolemia. Benefits also in normocholesterolemic pts with elevated markers of inflammation (e.g., CRP, Jupiter trial).

  • Unproven benefits: Conflicting data on effect of statins to reduce risk of sepsis, thrombotic disease, acute kidney injury following surgery or radiocontrast administration, ARDS, or mortality in ICU patient populations. Recent (2010–2015) multicenter clinical trials testing the impact of statins on these acute illnesses have largely been negative despite prior promising data.