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Purpose of Review <p>Statins are the first-line therapy for lipid-lowering and cardiovascular (CV) disease (CVD) prevention. Increasing evidence supports additional cardioprotective properties of statins through pleiotropic effects unrelated to lipid modulation. We aimed to discuss the pleiotropic effects of statins and their relevance to clinical outcomes in 2 reviews: Part I focuses on anti-inflammatory, antioxidant and immunomodulatory effects of statins, whereas Part II on statin-induced endothelial function improvement, plaque stabilization and anti-thrombotic effects. Part II also includes a clinical applications and future directions section.</p> Recent Findings <p>A literature search was conducted in Embase, Scopus, web of science, PubMed and Cochrane Library databases for experimental and clinical studies investigating the effects of statins on endothelial repair, plaque stability and thrombosis biomarkers. Statins were found to modulate immune cell phenotypes and endothelial repair pathways, as well as enhance plaque stability, inhibit thrombus formation and fibrin clot characteristics independent of lipids. Meta-analyses implicate these pleiotropic actions of statins with reduced CV events.</p> Summary <p> Statins offer cardioprotection through several pleiotropic pathways distinct from lipid-lowering. To maximize clinical benefits, statins’ therapeutic potential beyond CVD should be further explored via non-lipid mechanisms. An in-depth knowledge of statins’ pleiotropic effects may uncover novel preventive strategies and therapeutic applications.</p>

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Pleiotropic Effects of Statins: Focus on Endothelial Function, Plaque Stability and Thrombosis (Part II)

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Ali Mahmoudi,
  • Niki Katsiki,
  • Michal Vrablik,
  • Amirhossein Sahebkar

摘要

Purpose of Review

Statins are the first-line therapy for lipid-lowering and cardiovascular (CV) disease (CVD) prevention. Increasing evidence supports additional cardioprotective properties of statins through pleiotropic effects unrelated to lipid modulation. We aimed to discuss the pleiotropic effects of statins and their relevance to clinical outcomes in 2 reviews: Part I focuses on anti-inflammatory, antioxidant and immunomodulatory effects of statins, whereas Part II on statin-induced endothelial function improvement, plaque stabilization and anti-thrombotic effects. Part II also includes a clinical applications and future directions section.

Recent Findings

A literature search was conducted in Embase, Scopus, web of science, PubMed and Cochrane Library databases for experimental and clinical studies investigating the effects of statins on endothelial repair, plaque stability and thrombosis biomarkers. Statins were found to modulate immune cell phenotypes and endothelial repair pathways, as well as enhance plaque stability, inhibit thrombus formation and fibrin clot characteristics independent of lipids. Meta-analyses implicate these pleiotropic actions of statins with reduced CV events.

Summary

Statins offer cardioprotection through several pleiotropic pathways distinct from lipid-lowering. To maximize clinical benefits, statins’ therapeutic potential beyond CVD should be further explored via non-lipid mechanisms. An in-depth knowledge of statins’ pleiotropic effects may uncover novel preventive strategies and therapeutic applications.