Statins are a class of medication that reduce the level of LDL cholesterol (low-density lipoprotein, often called "bad" cholesterol) in the blood by inhibiting an enzyme in the liver (HMG-CoA reductase) involved in cholesterol production. They are one of the most prescribed and most evidence-based medications in cardiovascular medicine, and are frequently prescribed for cardiac arrest survivors, particularly those whose arrest was related to coronary artery disease.
Why statins matter after cardiac arrest
In survivors whose cardiac arrest was caused by or associated with coronary artery disease (blocked or narrowed coronary arteries), statins form a cornerstone of secondary prevention. By reducing LDL cholesterol, statins slow the progression of atherosclerosis (plaque build-up in the arteries), reduce the risk of plaque rupture, and have anti-inflammatory effects on the arterial wall.
Evidence
Major clinical trials have demonstrated that statins significantly reduce the risk of further heart attacks, stroke, and cardiovascular death in people with established coronary artery disease. In very high-risk patients (including those who have had a cardiac arrest due to coronary disease), high-intensity statin therapy (such as atorvastatin 80mg) is typically recommended.
Common statins
Atorvastatin and rosuvastatin are the most potent and most widely prescribed. Simvastatin, pravastatin, and fluvastatin are also available. Choice of statin may be influenced by other medications and individual factors.
Side effects
The most commonly reported side effect is muscle ache or weakness (myalgia). In rare cases, a more serious muscle condition (rhabdomyolysis) can occur. Liver enzyme abnormalities are occasionally seen. Most people tolerate statins well, and if one statin causes problems, switching to a different one often resolves the issue. Stopping statins without medical advice should be avoided, as the cardiovascular benefits are significant.
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