Statins and Perioperative Myocardial Infarction
Keywords:
Atherosclerosis, vulnerable plaque, inflammation, statinsAbstract
The growing prevalence of atherosclerosis means that perioperative myocardial infarction (PMI) is a significant issue for the anesthesiologist. Perioperative revascularization (if indicated medically), beta blocker (in high risk patients) and statin therapy are therapeutic modalities that are currently employed to reduce PMI. Statins not only lower low density lipoprotein levels but, via their actions on the isoprene pathway, exhibit pleiotrophic effects. Predominantly via their anti-inflammatory effects, statins stabilize vulnerable plaque and improve functioning of the endothelium in atherosclerosis. These effects appear to reduce perioperative complications of atherosclerotic lesions. It is important to have an understanding of newer developments in the pathophysiology of atherosclerosis to be able to appreciate the mechanisms of action of statins. The focus has changed from identification of stenotic coronary lesions to the identification of vulnerable plaque. This review is divided into 2 parts. The first part focuses on the pathophysiology of atherosclerosis while the second part discusses the pharmacology of statins and the mechanisms of how they may reduce PMI.
Published
2007-10-02
Issue
Section
Review Articles
License
By submitting manuscripts to SAJAA, authors of original articles are assigning copyright to the SA Society of Anaesthesiologists. Authors may use their own work after publication without written permission, provided they acknowledge the original source. Individuals and academic institutions may freely copy and distribute articles published in SAJAA for educational and research purposes without obtaining permission.
The work is licensed under a Creative Commons Attribution-Non-Commercial Works 4.0 South Africa License. The SAJAA does not hold itself responsible for statements made by the authors.