title: Biochemistry of Statins.
abstract: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Elevated blood lipids may be a major risk factor for CVD. Due to consistent and robust association of higher low-density lipoprotein (LDL)-cholesterol levels with CVD across experimental and epidemiologic studies, therapeutic strategies to decrease risk have focused on LDL-cholesterol reduction as the primary goal. Current medication options for lipid-lowering therapy include statins, bile acid sequestrants, a cholesterol-absorption inhibitor, fibrates, nicotinic acid, and omega-3 fatty acids, which all have various mechanisms of action and pharmacokinetic properties. The most widely prescribed lipid-lowering agents are the HMG-CoA reductase inhibitors, or statins. Since their introduction in the 1980s, statins have emerged as the one of the best-selling medication classes to date, with numerous trials demonstrating powerful efficacy in preventing cardiovascular outcomes (Kapur and Musunuru, 2008 [1]). The statins are commonly used in the treatment of hypercholesterolemia and mixed hyperlipidemia. This chapter focuses on the biochemistry of statins including their structures, pharmacokinetics, and mechanism of actions as well as the potential adverse reactions linked to their clinical uses.
authors.affiliation: Department of Clinical Medicine, Trinity College Dublin/The University of Dublin, Dublin, Ireland; Egom Clinical & Translational Research Services Ltd, Halifax, Nova Scotia, Canada. Electronic address: egom@ectrs.ca.
authors.forename: Emmanuel Eroume A
authors.initials: EE
authors.lastname: Egom
authors.affiliation: Egom Clinical & Translational Research Services Ltd, Halifax, Nova Scotia, Canada.
authors.forename: Hafsa
authors.initials: H
authors.lastname: Hafeez
mesh_terms: D001519:Behavior / Q000187:drug effects; D056486:Chemical and Drug Induced Liver Injury; D003071:Cognition / Q000187:drug effects; D003920:Diabetes Mellitus / Q000139:chemically induced; D004347:Drug Interactions; D050171:Dyslipidemias / Q000188:drug therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000737:chemistry / Q000493:pharmacokinetics* / Q000494:pharmacology* / Q000627:therapeutic use; D007674:Kidney Diseases / Q000139:chemically induced; D015394:Molecular Structure; D009135:Muscular Diseases / Q000139:chemically induced
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiovascular disease; Low-density lipoprotein cholesterol; Statins