Daniel Pella
Statins represent basic pillar in dyslipidemia treatment. They act via inhibition of key enzyme in biosynthesis of cholesterol ‒ 3-hydroxy-3-methyl glutaryl coenzyme A reductase. First statin was discovered by Japanese Endo. Actually, lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, rosuvastatin and pitavastatin (sequenced in time order when they became available in the market) are used in the common clinical practice. Cerivastatin was withdrawn from therapy due to serious muscle adverse effects (fatal rhabdomyolyses). The highest efficacy in lowering LDL-cholesterol was documented in atorvastatin and rosuvastatin, the lowest one in fluvastatin. Statins differ also in non-lipid (pleiotropic) effects and by their safety profile. However, the most important is variable effect on morbidity and mortality in various pre-defined groups of patients.