Statin-Induced Mitochondrial Damage

The discovery of statins, inhibitors of the enzyme 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMG-CoA reductase), meant a significant benefit in the treatment of hypercholesterolemia, in the primary and secondary prevention of cardiovascular diseases. HMG-CoA reductase is a key enzyme in the mevalonate metabolic pathway, its inhibition by statins reduces the formation of mevalonic acid, which is a precursor not only of cholesterol but also of isoprenoids, dolichol, coenzyme Q10 and other essential metabolites. In addition to hypolipidemic and pleiotropic effects, statin treatment may be associated with adverse effects on muscles, liver, pancreas, heart, and metabolism. The effects of statins in relation to mitochondrial function, CoQ10 deficiency and the importance of CoQ10 supplementation are being investigated in clinical and experimental studies. Although the conclusions of the conducted studies are not always consistent, CoQ10 supplementation is safe and recommended in statin treatment.