Lavinia Codruţa Gligor 1, Şerban Gligor 2, Virginia Gligor 1
1 West University “Vasile Goldiş”, Arad, Romania
2 West University, Timişoara, Romania
Abstract
Statins have an important role in stabilizing atherom plaque, in endothelial function improve and also has anti-inflammatory properties. The last inserted market statin is rosuvastatin calcium (Crestor®). This is a synthetic statin wich has similar action mechanism like other statins, being a competitive inhibitor of the HMG-CoA reductase. Compared with other statins, rosuvastatin, besides the main eff ect of decreasing LDLC, has tended to increase more than HDLC. Increase HDLC, like apolipoprotein A1 (apo A1) is probably mediated by decreasing cholesteryl ester transfer protein (CETP) activity, with a benefi cial effect on cardiovascular morbidity and mortality. In addition, rosuvastatin can signifi cantly decrease plasma triacylglycerol through its action on lipoproteins rich in this substance, having benefi cial eff ects in preventing atherosclerosis in diabetes type 2 patients. Treatment with 10 mg rosuvastatin has a greater effect of decreasing total cholesterol and LDLC and increasing adiponectin levels than atorvastatin. In addiction, it has a better eff ect of decreasing vascular biomarkers (hs-CRP, MMP 9, TNF- α, PAI 1, ET 1, tPA). A recent trial has shown a benefi cial effect of rosuvastatin 20 mg lowering LDLC, triglycerides and total apoB, along with a decrease of large and small particles of VLDL (VLDL1 and VLDL2) and IDL particles. Th is was achieved by signifi cantly increasing the catabolism of LDL-apoB, VLDL1-apoB, VLDL2-apoB, IDL-apoB and VLDL1-apoB production rate decrease. Also, it seems that rosuvastatin apparently acting modulating LDL size and subclass, in patients with increased risk of cardiovascular events. METEOR trial showed that maximum dose (40 mg/dL) rosuvastatin has signifi cantly slowed carotid intima media thickness, with a simultaneous reduction of cardiovascular events. This decrease was observed in middle-aged patients, with low Framingham score, low risk of coronary disease and evidence of subclinical atherosclerosis.