Pleiotropic effects: should statins be considered an essential component in the treatment of dyslipidemia?

Cardiovascular disease (CVD) is the leading cause of death in the developed world. Lower risks of morbidity and mortality in trials of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) have changed the conventional wisdom regarding lipid lowering. Since 2001, there have been surprising results concerning the early benefits of statin therapy, which suggest that some benefits may be derived from effects other than those of simply improving dyslipidemias.

Ultrasound-detected carotid plaque as a predictor of cardiovascular events.

Ultrasound detection of carotid plaque can be performed with equipment that is available in many clinical settings and can identify patients at increased risk of cardiovascular (CV) disease. We reviewed the literature to determine the CV risk factors associated with the presence of carotid plaque and whether its presence is associated with the presence and extent of coronary artery disease. A MEDLINE search subsequently was performed to determine whether carotid plaque burden predicts future CV events.

Skin cholesterol content identifies increased carotid intima-media thickness in asymptomatic adults.

Background: A noninvasive assay to measure skin Tc recently has become available for use in the outpatient setting as a cardiovascular (CV) risk prediction tool. The purpose of this study was to determine whether skin tissue cholesterol content (skin Tc) levels are associated with increased carotid intima-media thickness (CIMT) after adjusting for known CV risk factors and Framingham CV risk.

Methods: Consecutive patients without known vascular disease who were referred for determination of CIMT underwent B-mode ultrasonography of the carotid arteries and measurement of skin Tc using a noninvasive assay.

A semiautomated ultrasound border detection program that facilitates clinical measurement of ultrasound carotid intima-media thickness.

We have developed a novel, semiautomated carotid intima-media thickness (CIMT) border detection program (AUTO) and evaluated its measurement reproducibility and accuracy. Images from 6 carotid segments were acquired in 50 subjects, for a total of 300 segments. Mean and maximum CIMT values were measured blindly at a reference (REF) lab and in duplicate by experienced (EXP) and novice (NOV) readers using manual (MAN) and AUTO methods.

Effects of pravastatin on lipoproteins and endothelial function in patients receiving human immunodeficiency virus protease inhibitors.

Background: Although recommended as initial therapy for patients with dyslipidemia who are taking human immunodeficiency virus protease inhibitors (HIV PIs), the effects of pravastatin on lipoproteins and arterial reactivity have not been elucidated. The purpose of this study was to determine the effects of pravastatin on lipoprotein subfractions and endothelial function in patients with dyslipidemia who are receiving HIV PIs.

Methods: This was a placebo-controlled, double-blind, crossover study comparing pravastatin (40 mg) to placebo in 20 patients who were taking HIV PIs.