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Inicio Medicina Clínica (English Edition) Statins: pros and cons
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Vol. 150. Issue 10.
Pages 398-402 (May 2018)
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Vol. 150. Issue 10.
Pages 398-402 (May 2018)
Review
DOI: 10.1016/j.medcle.2018.03.001
Statins: pros and cons
Pros y contras de las estatinas
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Iago Pinal-Fernandeza,b,
Corresponding author
iago.pinalfernandez@nih.gov

Corresponding author.
, Maria Casal-Domingueza,b, Andrew L. Mammena,b
a National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, United States
b Johns Hopkins University School of Medicine, Baltimore, United States
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Abstract

Statins inhibit the critical step of cholesterol synthesis in which 3-hydroxy-3-methylglutaryl coenzyme A (HMGC) is transformed to mevalonate by the enzyme HMGC reductase. By doing so, they have a potent lipid-lowering effect that reduces cardiovascular risk and decreases mortality. Since the mevalonate pathway also influences endothelial function, the inflammatory response, and coagulation, the effects of statins reach well beyond their cholesterol lowering properties. As with all drugs, statins may have adverse effects; these include musculoskeletal symptoms, increased risk of diabetes, and higher rates of hemorrhagic stroke. However, the frequency of adverse effects is extremely low and, in selected patient populations, the benefits of statins considerably outweigh the potential risks.

Keywords:
Statins
Myositis
Diabetes
Stroke
Adverse effects
Resumen

Las estatinas inhiben el paso crítico de la síntesis del colesterol, donde la enzima 3-hidroxi-3-metilglutaril A (HMGC) se transforma en mevalonato por medio de la enzima HMGC reductasa. Al hacerlo, tiene un potente efecto reductor de lípidos que reduce el riesgo cardiovascular y disminuye la mortalidad. Como la vía del mevalonato influye también en la función endotelial, la respuesta inflamatoria, y la coagulación, los efectos de las estatinas van más allá de sus propiedades reductoras del colesterol. Como todos los fármacos, las estatinas pueden tener efectos adversos que incluyen síntomas musculoesqueléticos, incremento del riesgo de diabetes y tasas superiores de accidentes hemorrágicos. Sin embargo, la frecuencia de estos efectos adversos es extremadamente baja y, en poblaciones seleccionadas de pacientes, los beneficios de las estatinas superan con creces los riesgos potenciales.

Palabras clave:
Estatinas
Miositis
Diabetes
Accidente
Efectos adversos

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