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Statins: are any questions unanswered?

机译：他汀类药物：有未解决的问题吗？

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PURPOSE OF REVIEW: To summarize recent and ongoing randomized trials of statin therapy for the prevention of major vascular events. RECENT FINDINGS: Four large-scale randomized trials have compared high-dose vs. standard doses of statin therapy among patients with coronary heart disease, and their results suggest that higher doses are more effective for preventing major vascular events, albeit with evidence of increased toxicity. There is now clear evidence that statin therapy is effective among most patients with type 2 diabetes, although uncertainty remains about the benefits in those with advanced nephropathy. Ongoing trials will assess whether statin therapy is beneficial among patients with noncoronary vascular disease (such as congestive heart failure, cerebrovascular disease, or aortic stenosis), and among people with comorbid conditions or risk factors that increase the risk of vascular disease (including chronic kidney disease and raised C-reactive protein with below average low-density lipoprotein cholesterol). SUMMARY: Statin therapy safely reduces the risk of vascular events in a wide range of patients. Uncertainties persist about the effects of higher statin doses and the role of statins among patients with specific conditions or risk factors.
机译：审查的目的：总结近期和正在进行的他汀类药物预防重大血管事件的随机试验。最近的发现：四个大型随机试验比较了冠心病患者中他汀类药物的高剂量与标准剂量的治疗，他们的结果表明，尽管有增加毒性的证据，但高剂量对预防重大血管事件更有效。现在有明确的证据表明，他汀类药物疗法在大多数2型糖尿病患者中是有效的，尽管对于晚期肾病患者的益处尚不确定。正在进行的试验将评估他汀类药物疗法对非冠状血管疾病（例如充血性心力衰竭，脑血管疾病或主动脉瓣狭窄）患者以及合并症或具有增加血管疾病风险（包括慢性肾脏病）的危险因素的患者是否有益。疾病和C反应蛋白升高，而低密度脂蛋白胆固醇低于平均水平）。总结：他汀类药物疗法可安全地降低许多患者发生血管事件的风险。在具有特定病症或危险因素的患者中，关于他汀类药物较高剂量的作用以及他汀类药物的作用仍不确定。

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