Influence of lipid-lowering drugs on inflammation: what is yet to be done?
Sabina Ugovšek 1  
,   Janja Zupan 2  
,   Andreja Rehberger Likozar 3  
,   Miran Sebestjen 4, 1, 3  
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University of Ljubljana, Faculty of Medicine, Slovenia
University of Ljubljana, Faculty of Pharmacy, Department of Clinical Biochemistry, Slovenia
University Medical Centre Ljubljana, Department of Vascular Diseases, Slovenia
University Medical Centre Ljubljana, Department of cardiology, Slovenia
Miran Sebestjen   

University Medical Centre Ljubljana, Department of cardiology, Zaloska 7, 1000, Ljubljana, Slovenia
Submission date: 2021-01-20
Final revision date: 2021-02-20
Acceptance date: 2021-03-04
Online publication date: 2021-03-20
Atherosclerosis is a chronic inflammatory disease that is associated with risk of cardiovascular events. The best-characterised and well-standardised clinical indicator of inflammation is C-reactive protein. Current evidence-based drug therapies for prevention and treatment of cardiovascular diseases are mainly focused on reduction of low-density lipoprotein cholesterol. However, these drugs do not provide sufficient protection against recurrent cardiovascular events. One of the possible mechanisms behind this recurrence might be the persistence of residual inflammation. For the most commonly used lipid-lowering drugs, the statins, their reduction of cardiovascular events goes beyond lowering of low-density lipoprotein cholesterol. Here, we review the effects of these lipid-lowering drugs on inflammation, in terms of statins, ezetimibe, fibrates, niacin, proprotein convertase subtilisin/kexin type 9 inhibitors, bempedoic acid, ethyl eicosapentaenoic acid and antisense oligonucleotides. We focus in particular on C-reactive protein, and discuss how the effects of the statins might be related to reduced rates of cardiovascular events.