ABSTRACT
Clinical trials of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors
(statins) have presented clinicians with a puzzle. Statins not only improve survival of
patients at high risk for coronary heart disease with elevated low density lipoprotein (LDL)
cholesterol, but also benefit patients with moderate risk and average LDL levels. Even
more puzzling, statins may also benefit patients with dilated cardiomyopathy by
decreasing symptoms and increasing the ejection fraction. Most puzzling of all, recent
studies have found that statins improve outcomes in diseases as diverse as cancer,
osteoporosis, and Alzheimer’s Disease-all diseases in which LDL is not thought to play a
significant role. These novel benefits of statins have raised the question: Do statins benefit
patients by decreasing lipids, modulating inflammation, or through other pathways?
