Introduction: Principles of therapeutics of fluvastatin

Therapeutic strategies for the prevention of atherosclerosis are essentially based on the correction of major risk factors, such as elevated plasma lipid levels or arterial blood pressure. These interventions have been successful in inducing regression of vascular atherosclerosis, decreasing the incidence of cardiovascular disease, and improving survival in CAD patients. However, with the increasing knowledge of the pathogenesis of atherosclerosis, it appears that the prevention of cardiovascular disease in the future will involve, besides risk factor correction, direct pharmacological control of processes occurring in the arterial wall. These events are largely modulated by factors (growth factors, cytokines, etc.) whose finely tuned balance is modified in areas where the atherosclerotic plaque is developing. Statins, beyond their lipid-lowering effect, interfere with several of these events. It appears that their actions on these processes are linked to the modulation of the mevalonate pathway and could translate into a more significant prevention of cardiovascular disease. Finally, statins due to their ability to improve vascular endothelial function combined with their direct antiatherosclerotic properties, may potentially become part of our therapeutic armamentarium not only for the treatment of hypercholesterolemia but also for the treatment of ischemic coronary syndromes.