Estatinas
uma revisão sobre aspectos vasculares
Palavras-chave:
Antioxidantes, Endotélio vascular, Inibidores de Hidroximetilglutaril-CoA redutase, Óxido nítricoResumo
As estatinas tornaram-se os fármacos redutores de lipídios mais amplamente prescritos na maioria dos países. Os efeitos que não dependem dessa redução são chamados de pleiotrópicos, entre os quais pode-se citar: melhora na função endotelial, recrutamento de novas células precursoras endoteliais, efeitos antioxidantes e efeitos anti-inflamatórios. Em uma revisão sistemática da literatura nacional e internacional pelo indexador Medline/PubMed, utilizando os unitermos: estatinas, disfunção endotelial, óxido nítrico, endotelina, neovascularização e anti-inflamatório, observouse que nos últimos anos foram atribuídas outras propriedades às estatinas. As estatinas atuam sobre as células do endotélio vascular interferindo na biodisponibilidade de óxido nítrico e endotelina-1 e recrutamento de novas células precursoras endoteliais; possui ainda efeitos antioxidante e anti-inflamatório. Tais efeitos são mediados pela redução dos níveis dos intermediários da via do ácido mevalônico, os chamados isoprenóides, responsáveis por uma série de vias de sinalização intracelular. Esses conhecimentos podem fornecer benefícios adicionais sob a forma de redução de risco, representando novas perspectivas de tratamento, auxiliando no entendimento dos benefícios encontrados e ajudando a prevenir riscos com o uso prolongado destes fármacos, o que pode causar um impacto positivo na redução dos altos índices de morbimortalidade em pacientes portadores de doenças cardiovasculares. Assim, apesar das limitações relacionadas a ações multifatoriais, novos estudos considerando esses efeitos e uma maior compreensão dos mecanismos lipídicos e pleiotrópicos das estatinas podem mudar alguns paradigmas referentes ao desenvolvimento de novas terapias cardiovasculares. Termos de indexação:
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