جستجوی مقالات مرتبط با کلیدواژه "statins" در نشریات گروه "پزشکی"

 Statin therapy is widely used for the management of dyslipidemia and the prevention of cardiovascular diseases (CVDs). However, there is a growing concern about its potential effects on bone metabolism markers and mineral density. The aim of this systematic review and meta-analysis was to investigate the effect of statin therapy on these parameters.

 PubMed/MEDLINE, Scopus, and Clarivate Analytics Web of Science databases were searched from inception to August 2023, using MESH terms and keywords.

 After screening 2450 articles, 16 studies that met the inclusion criteria were included, of which 12 randomized controlled trials (RCTs) were used for meta-analysis. The findings showed that statin therapy significantly reduced bone-specific alkaline phosphatase (B-ALP) levels (WMD=-1.1 U/L; 95% CI -2.2 to -0.07; P=0.03; I2=0%,), and bone mineral density (BMD) at different sites (WMD=-0.06 g/cm2 ; 95% CI -0.08 to -0.04; P<0.001; I2=97.7%, P<0.001). However, this treatment did not have a significant effect on osteocalcin, serum C-terminal peptide of type I collagen (S-CTx), serum N-telopeptides of type I collagen (NTx) concentration, or overall fracture risk.

 This systematic review and meta-analysis provide evidence that statin therapy is associated with a significant reduction in B-ALP levels and BMD at different sites of the skeleton. Further studies are needed to investigate the long-term effects of statin therapy on bone health and to identify the potential underlying mechanisms.

The combination of aspirin (ASP) and clopidogrel (CLD) has demonstrated efficacy in managing coronary syndromes, including unstable angina and myocardial infarction. This regimen prevents clotting and effectively reduces the risk of vascular events by inhibiting both adenosine diphosphate and the cyclooxygenase pathway. Furthermore, cholesterol-lowering agents such as statins are also employed as a preventive measure for patients with acute coronary syndromes (ACS). This article reviews the current analytical methods for the quantitative determination of aspirin in combination with clopidogrel, or the combination of the two drugs with one of the statins, in various marketed formulations in the period of 2005 -2024. The most commonly used methods for determining these combinations include chromatographic techniques such as high-pressure liquid chromatography (HPLC) and thin-layer chromatography (TLC), as well as spectrophotometric methods. Recent trends in the analysis of these combination samples show a preference for HPLC (60%), thin-layer chromatography (TLC) (22.5%) and spectrophotometric methods (17.5%) reflecting a general shift towards more sensitive methods with higher resolution capabilities. These methods also offer the advantages of requiring smaller quantities of samples and reagents and shorter analysis times.

Since the prevalence of pressure ulcers has been increasing in recent years, they need a new and efficient treatment. The pleiotropic effects of statins can be used for this purpose. This study aimed to evaluate the appropriate formulation of 3% simvastatin (SIM) topical cream and its effect on the healing of bedsores. At first, the appropriate formulation of SIM topical cream was investigated. In a randomized, double-blind trial, 42 patients were divided into two groups: placebo and SIM cream, and used these creams for three weeks, once every 12 hours on a clean bedsore. Bedsore dimensions were measured at the beginning and end of the study. Seventy-seven percent of patients in the SIM group and 35% in the placebo group had more than 20% healing of bedsores. Age (P=0.03), gender (P=0.01), statin use (P=0.04), and diabetes (P=0.04) had statistically significant impacts on bedsore healing. Also, better wound healing in the non-diabetic patients was observed. It seems that the topical cream of SIM significantly affects the healing of bedsores and can also be used in bedsores of diabetic patients. In diabetic patients with bedsores, blood sugar control through nutritional counseling and consumption of regular diabetic medication seems to be very effective and efficient.

Acute coronary syndrome (ACS) is one of the main causes of mortality worldwide, and dyslipidemia is one of its important risk factors. Studies have shown that treatment with high-intensity statins protects against cardiovascular events; other investigations have noted that despite the potential effects of statins, 80% of patients with ACS fail to lower cholesterol levels. We conducted the present study to determine the association between medical compliance to clinical practice guidelines (CPG) and changes in low-density lipoprotein cholesterol (LDL-C) at follow-up among patients with ACS.
 
We performed a prospective cohort study on patients diagnosed with ACS. We enrolled 79 adult patients from August 2019 through March 2020. Data on patient characteristics at presentation, hospitalization, and 8 months of follow-up were collected. Adherence was established as a high-intensity statin prescription at discharge according to Peruvian, European Society of Cardiology (ESC) 2019, and American Heart Association (AHA) 2018 guidelines.
 
Adherence to AHA and ESC guidelines showed a reduction in mean LDL-C values of 44.2 mg/dL (P = 0.14). In patients with dyslipidemia, mean LDL-C values were reduced by 60.6 mg/dL (P < 0.001). Only 27.8% of the patients did not achieve any goal in their LDL-C levels following the AHA or ESC guideline recommendations.
 
Due to the high prevalence of dyslipidemia, adequate primary prevention before an acute event occurs is essential. Compliance with CPG by healthcare personnel is related to a reduction in LDL-C levels at follow-up, and patient adherence is essential to achieve LDL-C targets. (Iranian Heart Journal 2023; 24(4): 54-62)

Statins are the most important lipid lowering drugs and their protective effects in primary or secondary cardiovascular diseases (CVDs) have been well documented. However, various number of evidences have revealed that the beneficial effects of statins regarding the CVDs are not only due to their blood cholesterol lowering properties but also because of their pleiotropic effects such as inhibition of isoprenoids synthesis, immunomodulation and neuroprotection. Type 2 diabetes mellitus (T2DM) is a systemic disease with inflammatory properties and micro/macro-vascular complications. Despite the beneficial effects of statins to lower blood cholesterol level, mortality decrease due to CVD and stroke, dyslipidemia improvement, and their anti-inflammatory and anti-coagulatory properties have not well been studied, especially in T2DM. In this review, we discuss the pharmacology, pleiotropic effects, dose prescribing and side effects of statins with a focus on type 2 diabetes.

Cancer is a primary cause of mortality around the world and imposes a significant physiological, psychological, and financial burden on patients. Lipids regulate cell cycle progression and affect cell proliferation, migration, and apoptosis. Therefore, alterations in serum lipid levels might contribute to carcinogenesis. In this article, we review the relationships between triglyceride (TG), total cholesterol, high?density lipoprotein cholesterol (HDL?C), and low?density lipoprotein cholesterol (LDL?C) levels and different types of cancer. Then, we examine the association between cancer and familial hypercholesterolemia. Finally, we evaluate the impact of statins on different types of cancer. Increased total cholesterol has been reported to increase cellular proliferation and angiogenesis in tumors and inhibit apoptosis. Increased LDL?C has been reported to induce inflammation and increase susceptibility to oxidative damage. HDL?C has anti?oxidation, anti?inflammatory, and  ntiproliferative properties. Increased levels of serum TG can induce oxidative stress and a chronic inflammatory state and therefore ontribute to the proliferation and progression of cancer cells. Statins decrease downstream products of cholesterol synthesis that are crucial in cell proliferation and growth. Thus, lipid components can have prognostic value in cancer and management of serum lipid levels through lifestyle changes and medical therapy can be beneficial in cancer prevention and treatment.

Among the many types of central nervous system (CNS) disorders, seizures and epilepsy severely affect the quality of life and routine daily activity of the sufferers. We aimed to review research studies that investigated the effect of statins on the prevention and treatment of seizures and epilepsy. Both animal models and human studies were included in this review. This article starts with a brief introduction about seizure, its prevalence, treatment, and various animal models of seizures and epilepsy. Next, we discuss statin’s mechanism of action, side effects, and effects on neurological disorders with a specific focus on seizures. Finally, the effects of different types of statins on seizures are compared. The present review gives a better understanding of the therapeutic effects of statins on neurological disorders in animal models and human studies. This permits researchers to set up study designs to resolve current ambiguities and contradictions on the beneficial effects of statins on neurological disorders.

To study the role of statin therapy on diabetic retinopathy (DR) progression.

This retrospective study was carried out at a tertiary care hospital in southern India. Data were collected from the medical records of patients admitted from January 2013 to December 2018. Out of 1673 patients of DR enrolled in the study, 171 met the inclusion criteria. Patients’ demographic data, drug history, clinical characteristics, and laboratory investigations were recorded as per the pro forma. The patients were divided into statin users and nonusers. The results were analyzed to compare the DR progression between the two groups.

DR progressed in 67% of nonstatin users and 37% of statin users (P < 0.001). The use of statins decreased the risk of DR progression (P < 0.001). Center‑involving macular edema was seen in 8 of 79 statin users (10%) and 16 of 92 statin nonusers (16%) based on optical coherence tomography findings during the follow‑up period (P = 0.17).

In patients with type 2 diabetes, lipid‑lowering therapy with statins has the potential to retard DR progression.

The world is still witnessing a largely ongoing spread of coronavirus disease 2019 (COVID-19); therefore, the scientific findings in this area need to be shared promptly. This study aimed to assess the usefulness of Atorvastatin treatment in reducing COVID-19 mortality in patients with or without diabetes mellitus (DM) and to correlate them with C-reactive protein (CRP) levels. This study consecutively enrolled patients with pneumonia symptoms, positive lung CT scan, and confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on reverse transcription-polymerase chain reaction (RT-PCR). The outcome was defined as intensive care unit (ICU) admission and death. Clinical data and history of atorvastatin administration were evaluated. CRP levels were measured at baseline and repeated after one week in all patients. A total of 200 patients were included. Their mean age was 60.5 (SD = 16.5) years, 113 (56.5%) patients were male, 47 (23.5%) with pre-existing diabetes, and 64 (32%) patients were taking atorvastatin routinely. 68 (34%) required ICU admission of all the studied patients. No gender differences were found in ICU admission and death. The baseline CRP was not significantly different, but the secondary CRP was significantly different between DM and non-DM groups. Secondary CRP also showed a significant reduction in patients receiving atorvastatin (P = 0.017). The mortality was the same in atorvastatin or non-atorvastatin groups (P = 0.715). It seems that taking statin has only some beneficial effects on improving CRP levels in patients with COVID-19. To achieve a reliable result, clinical trials are recommended.

Iodinated contrast agents are commonly used in diagnostic radiography techniques along with therapeutic interventions. Contrast-Induced Acute Kidney Injury (CI-AKI) is a significant problem of all angiographic procedures, triggered by the use of Iodinated Contrast Media (ICM). There are conflicting data concerning the prevention and treatment of CIAKI. Numerous approaches have been studied to prevent CI-AKI, but the therapy of choice remains undetermined. The cornerstones of CI-AKI prevention include low-osmolar ICM and intravenous hydration. The recommended hydration must be achieved by means of an isotonic solution of saline. Statins were tested against AKI due to their anti-inflammatory action and antioxidant effect on endothelial function. Novel approaches are required to investigate the short-term effects of high dosage atorvastatin versus sodium bicarbonate on CI-AKI prevention. The objective of this review is to compare the findings of various studies that had applied different doses of statins, sodium bicarbonate, and other agents for preventing CI-AKI.

The global incidence of resistance to commonly used antibiotics was a challenging public health concern which justifies the urgency in the development of novel antibacterial agents. ATP dependent Mur ligases (MurC, MurD, MurE and MurF) are considered as validated targets in antibacterial drug design. Drug repurposing or drug repositioning is an alternative strategy in identifying new indications for the currently approved drugs. Statins are currently FDA approved drugs used to treat hyperlipidemia. The pleiotropic effects of statins along with their anticipated antibacterial properties encouraged us to investigate them against MurD ligase of Escherichia coli and Staphylococcus aureus. The molecular docking and MMGB-SA studies revealed that amongst all selected statins, pravastatin exhibited higher binding affinity with the catalytic residues of Escherichia coli (-7.24 kcal/mol and -88.36 kcal/mol) and Staphylococcus aureus (-7.47 kcal/mol and -63.75 kcal/mol) MurD ligases. Further 20 ns MD simulation showed stability and favorable interaction pattern of pravastatin with both enzymes.

Adherence to lipid-lowering drugs could be challenging in our patients as it is in the general population, which is described as low as 25%. Our aim was to evaluate adherence to statins and to investigate clinical event impact on it.

This retrospective study on HIV+ patients attending to Clinic of Modena (Italy) was conducted in order to evaluate characteristics, clinical events, and adherence on lipid-lowering drugs. All drugs for comorbidities are distributed by the hospital pharmacy and recorded in an electronical database. Adherence was also evaluated in patients who were supplied with antilipemics in external pharmacies through phone calls. Patients were considered adherent if the percentage of correct time of drug refill was >80%.

Totally 1123 patients were evaluated. Lipid‑lowering drugs (statins, fenofibrate, and omega‑3 oil) were prescribed in 242 patients (21.5%). Prescription occurred mainly in those who were older, males, and Italians. Two hundred of them (82.6%) used statins alone, 23 (9.5%) only fenofibrate or omega‑3 oil, and 19 (7.8%) a combination of both drugs. The median adherence was 90% while patients with adherence >80% resulted 153 (63.2%). Forty-six (19%) had a clinical history of cardiovascular events; 59% of them, placed in secondary prophylaxis, and 76%, already in treatment, continued to adhere. No differences in terms of adherence according to the type of drug distribution (hospital pharmacy or outside pharmacies) were found.

Linking the supply of these drugs to that of antiretrovirals led to a good level of adherence higher than that described in the general population. The majority of the patients who experienced a cardiovascular event remain adherent to the prescribed therapy

Internal reference pricing (IRP) is one of the pharmaceutical pricing approaches, which is widely favored by health policymakers in different countries as a cost-containment tool for managing medicine expenditure. Evidence related to the implementation of this method confirms its usefulness in reducing pharmaceutical costs. Accordingly, the purpose of this study was to calculate potential changes in pharmaceutical expenditure using the IRP method for products belonging to three pharmaceutical categories in the pharmaceutical system of Iran.

This routine data study assessed the potential effect of IRP in three pharmaceutical categories including statins, non-steroidal anti-inflammatory drugs, and proton pump inhibitors (PPIs). Two scenarios for reference groups (levels 4 and 5 of the ATC code) and four scenarios for the reference price (i.e., the minimum, median, mean, and the mean of three minimum prices in the reference group) were considered in this regard, and the price and sales data source was the report published by the Iranian Food and Drug Administration. Then, cost changes were calculated with each hypothetical scenario. It was assumed that other intervening factors remain unchanged, including consumers and prescribers’ behavior.

Based on the results, the two largest potential saving effects belonged to the minimum price scenario and the mean of the scenario of the three minimum prices, respectively. However, the results showed that the consequence of using a price scenario other than the minimum price as the reference price is highly related to the details of the distribution of prices in the related reference group. In addition, appropriate decisions regarding outlier products (e.g., imported products) might have extremely important effects on the result, especially for the mean price scenario. The minimum price scenario concomitant with a premium for superior products can also be considered, but part of it is outside the scope of this study and requires independent research.

Thus if an appropriate scenario is selected for the reference price and group, the IRP method has the potential to reduce the costs of medicines. Therefore, pharmaceutical policymakers must pay enough attention to the details of planning this system and the needed procedure for updating the details of this system.

Hand eczema (HE) refers to a common inflammatory dermatological condition. Several studies have shown that statins may have anti-inflammatory effects. This study aimed at investigating the efficacy of adding topical atorvastatin to topical betamethasone in the treatment of chronic HE.

This randomized, double-blind, placebo-controlled research was done between October 2017 and August 2018 in Hamadan, Iran. Of 130 cases treated for HE, 88 were randomly assigned to groups receiving either betamethasone 1% ointment plus atorvastatin 5% cream (n = 44) or betamethasone 1% ointment plus vehicle cream (n=44). Both groups applied their medications twice a day for 10 days. The primary outcome was changes in the severity of HE, assessed by hand eczema severity index (HECSI). The secondary outcomes were changes in itching evaluated via visual analogue scale (VAS) and quality of life examined through dermatology life quality index (DLQI).

Seventy-two out of 88 eligible cases completed the study. The mean HECSI scores decreased in both groups after the intervention, although the change in HECSI was greater in the atorvastatin group (adjusted mean difference [AMD]: 5.756; 95% CI: 5.168 to 6.344, P<0.001). The mean VAS scores decreased in both groups after the intervention, although the change in VAS was greater in the atorvastatin group (AMD: 10.535; 95% CI: 7.005 to 14.064, P<0.001). Treatment with topical atorvastatin was more effective in improving DLQI (AMD: 1.990; 95% CI: 1.821 to 2.158, P<0.001).

Addition of topical atorvastatin to topical betamethasone is beneficial in treatment of chronic HE.

Chronic obstructive lung disease (COPD) is a chronic multisystem disease with a considerable burden. One of its most common complications is pulmonary artery hypertension (PAH). It has been demonstrated that the development of PAH is correlated with decreased quality of life and survival. Different medications have been proposed for the treatment of PAH, among which one can name statins. However, the same as other medications for the treatment of PAH, statins are still providing controversial results across different study settings. Moreover, the effect of statins on PAH in COPD patients has not been widely investigated so far. According to the present review, most of the available clinical trials demonstrated that the utilization of statins, including pravastatin, atorvastatin, and rosuvastatin may have beneficial effects on PAH in COPD patients. Nonetheless, it is necessary to conduct clinical trials with longer follow-up duration

The aim of the present study was to demonstrate the possible role of statins on the inflammatory biomarkers in patients with periodontal disease (PD).

This cross-sectional study involved 74 patients with PD and/or dyslipidemia divided into Group A: 34 patients with PD (nonstatins users); Group B: 40 patients with PD (statins users); and Group C: 30 healthy controls. Total cholesterol (TC), triglyceride (TG) and high-density lipoprotein, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and malondialdehyde (MDA) were measured . Blood pressure prolife and indices of PD were evaluated in each group. Statistical analysis was conducted by using SPSS version 20.0.

Inflammatory and lipid peroxidation biomarkers were higher in patients with PD compared with controls; IL-6, CRP, TNF-α, and MDA sera level were high in PD compared with controls (P = 0.001). Statins therapy led to significant reduction of TC, TG, very low and low-density lipoproteins, blood pressure profile, and cardiac risk indices with elevation in high-density lipoprotein compared with nonstatins users (P < 0.01). Statins therapy led to significant reduction in IL-6, CRP, TNF-α, and MDA sera levels compared with nonstatins users (P < 0.05).

Statins therapy reduced PD-induced inflammatory changes in patients with chronic PD through reduction of inflammatory cytokines.

Statins are the inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A, which are extensively used to decrease the concentration of cholesterol in patients with hyperlipidemia. Statins are divided into two categories based on their own unique properties. Considering the pleiotropic effects of statins, they are applied as antioxidant, anti-inflammatory, anti-thrombotic, immunomodulatory, and plaque-stabilizing agents. In addition, statins affect the diversity and population of gut microbiota, which is a complicated microbial community remarkably involved in the regulation of metabolic responses, immune system, and human health. This community is also associated with age-related health problems, allergy, asthma, and inflammatory intestinal diseases. Therefore, evaluation of the interactions between statins and gut microbiota is essential to predicting the outcomes of these agents. The present study aimed to review the properties and pleiotropic effects of statins. Furthermore, the role of gut microbiota in health was discussed, and the significant effects of statins on gut microbiota and their interactions were described based on clinical and animal studies.