Đang chuẩn bị liên kết để tải về tài liệu:
Báo cáo y học: "Statins for acutely hospitalized patients: randomized controlled trials are long overdue"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Statins for acutely hospitalized patients: randomized controlled trials are long overdue. | Bernard Critical Care 2010 14 141 http ccforum.eom content 14 2 141 CRITICAL CARE COMMENTARY L__ Statins for acutely hospitalized patients randomized controlled trials are long overdue Gordon R Bernard See related research by Christensen etal. http ccforum.eom content 14 2 R29 Abstract From the earliest studies of statins for control of plasma cholesterol observations have been made that the reductions in mortality observed occurred in a manner seemingly independent from what could be anticipated from cholesterol lowering alone. Over the last decade the pleiotropic effects of statins have been increasingly elucidated. Perhaps most intriguing are the effects statins appear to have on the immune system especially the modulation of diffuse or systemic inflammation. There is a growing body of observational literature suggesting that statins can actually reduce hospital mortality through mechanisms far beyond those that can be explained by reductions in cardiovascular events. In this issue of Critical Care Christensen and colleagues 1 present data suggesting that patients who chronically take statins have improved survival during acute hospitalizations and for at least 1 year thereafter. Statins are now recognized to have numerous pleiotropic Greek pleion many tropos turns effects. As a pharmaceutical drug class statins inhibit the reduction of hydroxymethyl-glutaryl-CoA HMG-CoA reductase to mevalonate. Mevalonate is a substrate for cholesterol synthesis hence the use of statins for control of hypercholesterolemia. Mevalonate is also involved in the synthesis of bile acids certain steroid hormones and vitamin D. Statins also inhibit the production of cyclooxygenase-2 COX-2 protein and are upstream in the biosynthesis of ubiquinone mitochondrial respiration and heme-A oxygen transport and prenalation of small G proteins acting as molecular switches. All of these Correspondence gordon.bernard@vanderbilt.edu Department of Medicine Vanderbilt University School of .