Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jun 18;2(1):19.
doi: 10.1186/2110-5820-2-19.

Statins in the critically ill

Isabelle De Loecker  1 , Jean-Charles Preiser
Affiliations

Statins in the critically ill

Isabelle De Loecker et al. Ann Intensive Care. .

Abstract

The use or misuse of statins in critically ill patients recently attracted the attention of intensive care clinicians. Indeed, statins are probably the most common chronic treatment before critical illness and some recent experimental and clinical data demonstrated their beneficial effects during sepsis, acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), or after aneurismal subarachnoidal hemorrhage (aSAH). Due to the heterogeneity of current studies and the lack of well-designed prospective studies, definitive conclusions for systematic and large-scale utilization in intensive care units cannot be drawn from the published evidence. Furthermore, the extent of statins side effects in critically ill patients is still unknown. For the intensive care clinician, it is a matter of individually identifying the patient who can benefit from this therapy according to the current literature. The purpose of this review is to describe the mechanisms of actions of statins and to synthesize the clinical data that underline the relevant effects of statins in the particular setting of critical care, in an attempt to guide the clinician through his daily practice.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Effects of statins on the cholesterol biosynthesis pathway. HMG-CoA reductase inhibition by statins reduces intracellular mevalonate levels. Consequently, not only cholesterol levels are reduced but also the intermediary products farnesylpyrophosphate and geranylgeranylpyrophosphate. These latter two provide binding sites for protein isoprenylation, and activation.
Figure 2
Figure 2
Pleiotropic effects of statins. Statins have anti-inflammatory, immunomodulatory, antithrombotic, and antioxidant properties found independently of their lipid-lowering properties. Because statins do not target individual inflammatory mediators, they could modulate the overall magnitude of the inflammatory response.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Haute Autorité de Santé. Efficacité et efficience des hypolipemiants. Paris: une analyse centrée sur les statines; 2010.
    1. Stagnitti MN. Medical Expenditure Panel Survey: Statistical Brief #205. Rockville: Agency for Healthcare Research and Quality; 2008. Trends in statins utilization and expenditures for the U.S. civilian noninstitutionalized population, 2000 and 2005. - PubMed
    1. The Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S) Lancet. 1994;344:1383–1389. - PubMed
    1. Shepherd J, Cobbe M, Ford I. et al.Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary prevention study group. N Engl J Med. 1995;333:1301–1307. - PubMed
    1. Ridker PM, Danielson E, Fonseca FA. et al.Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–2207. doi: 10.1056/NEJMoa0807646. - DOI - PubMed

LinkOut - more resources