Table of Contents    
EDITORIAL
Year : 2016  |  Volume : 7  |  Issue : 2  |  Page : 117-118  

Hoping rosuvastatin for primary prevention of cardiovascular events, are all statins similar and are we ready for statinizing the globe?


Editor in Chief, Journal of Natural Science, Biology and Medicine, University College Dublin, Dublin, Ireland

Date of Web Publication27-Jun-2016

Correspondence Address:
Arun H. S. Kumar
Editor in Chief, Journal of Natural Science, Biology and Medicine, University College Dublin, Dublin
Ireland
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-9668.184694

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How to cite this article:
Kumar AH. Hoping rosuvastatin for primary prevention of cardiovascular events, are all statins similar and are we ready for statinizing the globe?. J Nat Sc Biol Med 2016;7:117-8

How to cite this URL:
Kumar AH. Hoping rosuvastatin for primary prevention of cardiovascular events, are all statins similar and are we ready for statinizing the globe?. J Nat Sc Biol Med [serial online] 2016 [cited 2020 Jan 21];7:117-8. Available from: http://www.jnsbm.org/text.asp?2016/7/2/117/184694

Earlier this year the results from Heart Outcomes Prevention Evaluation (HOPE-3) trial were published, which strongly supported the potential use of rosuvastatin for the primary prevention of cardiovascular events. Considering the global socioeconomic burden of cardiovascular diseases, which span from acute to chronic events, the outcomes of HOPE-3 are promising. Statins inhibit 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase enzyme, which has a key role in the production of cholesterol. Hence, statins by blocking HMG-CoA reductase enzyme are useful as lipid lowering therapeutics and have specifically been beneficial in patients with high cholesterol levels and as secondary prevention measures in patients suffering from cardiovascular events. Currently, the following seven statins are approved for clinical use, i.e. lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, rosuvastatin, and pitavastatin. While lovastatin and simvastatin are naturally derived the other four are chemically synthesized. Despite the structural similarities between the synthetic statins, pharmacologically they are unique and probably different. For instance, pitavastatin is reported to enhance high-density-lipoprotein-cholesterol levels while rosuvastatin is reported to increase nitric oxide (NO) bioavailability and due to its sulfur content may potentially exhibit antioxidant effects. Other members of the statin group do not share these pharmacological properties of pitavastatin and rosuvastatin. The increase in NO bioavailability by rosuvastatin is specifically of interest as this can independently have cardiovascular benefits. Since the authors of HOPE-3 trial did not control for NO bioavailability in their placebo group, generalizing the benefits observed in rosuvastatin group to other members of the statin family is not appropriate. This necessitates the need to understand the detailed mechanisms involved in the benefits observed with low-dose rosuvastatin use, until which extending rosuvastatin for primary prevention for cardiovascular events is unjustified, specifically concerning the potential side effects associated with statins use impacting patients quality of life. Based on the HOPE-3 trial outcome, probably over 50% of the global population may qualify for using at least rosuvastatin statin for primary prevention of cardiovascular events, such a pandemic approach to statinizing the global population should be rationalized with robust evidence-based medical need rather than commercial greed. A collateral topic associated with this is the need for effective and optimal control groups in any scientific research as a means to derive reliable and valid conclusions. Hence, scientific study designs must emphasize on selecting the right control groups, without which the reliability and validity of any study will always be questioned.

Cardiovascular diseases are the leading cause of morbidity and mortality globally; this trend continues to be aggravated by lifestyle and environmental factors at a pandemic scale. Hence, efforts to identify cardiovascular diseases at an as early phase as possible are necessary to optimally cure or curtail them. Patients with diabetes are particularly at a higher risk of developing cardiovascular diseases. In this issue, we have an article, which reports the utility of serum low-density lipoprotein-cholesterol and hyperuricemia as valuable and independent predictors of coronary artery disease among Asian-India patients with type-2 diabetes. The association and alarming rise in the incidence of renal failure among diabetic patients is indeed of considerable concern and needs through investigation both from biomarkers and therapeutics standpoint. Unlike cardiovascular diseases, cancers have a major socio-psychological impact on patient quality of life. Hence, efforts to developing better and effective anti-cancer drugs are the major focus among several biotech and pharmaceutical organization. In this issue, we have included a review article on one such anti-cancer drug, i.e., gefitinib and its potential in the treatment of nonsmall cell lung cancer. We also have another article on the incidence of polycystic ovarian syndrome (PCOS), which is reported to be a common disorder among young women, necessitating regular screening. It is interesting that just like cardiovascular diseases, socioeconomic factors can also influence the incidence of PCOS. Measures to address the socioeconomic factors in limiting the disease incidence seems to be considerably ignored both by the health sectors and as well as the policy makers. This aspect is specifically highlighted by two manuscripts in this issue, which reports the vital role of socioeconomic factors influencing oral and general health among school and tribal children. While we know the solution to the problem, making the solution to a problem available at the local level is often a challenging task. Collaterally creating awareness about the solution to a problem is also necessary and hence, public health measures and strategies with universal inclusive approach can play a vital role in improving community health. A closely related issue to this is the aspects of self-medication practice, which is very widely prevalent in regions lacking adequate healthcare professionals. One of the articles in this issue reports the self-medication practice and factors influencing it among medical and paramedical students in India. In my opinion, creating awareness on top of stringent regulations for dispensing prescription drugs will be necessary to curtail the problem of self-medication.

Increase in the lifespan, especially in the developed nations, has resulted in higher number of geriatric patients, who in addition to cardiovascular diseases may also have other musculoskeletal ailments, which often require surgical-based correction procedures. In this issue, we have one article reporting the utility of uncemented total hip replacement (THR) in patients with osteoarthritis. Based on a midterm clinical and radiological outcomes, the authors conclude that uncemented-THR resulted in an optimal functional outcome and better quality of life for patients with osteoarthritis. Surgical advancements driving the limits of therapeutic outcomes are required not only in orthopedics but also in other clinical sectors, and we very much look forward to authors submitting such studies for publication in Journal of Natural Science Biology and Medicine (JNSBM). Yet, another article reports the comparative performance of various pressure syringes in root canal therapy, with the feasibility of using locally available tools as an effective replacement in the root canal treatment procedure. Identifying such viable and economical alternatives is necessary in widening the reach of medical procedures. Reflecting this concept is one of the articles in this issue comparing the effectiveness of curcumin gel with chlorhexidine gel in the treatment of mild to moderate periodontal pockets. Last but not the least, we have an article in the board area of bioinformatics reporting a new tool named prefiber reinforced polymer, which can be used for prediction and visualization of fluctuation residues in proteins. Understanding of such fluctuation in protein residues is of increasing interest, especially with the rise in the number of peptides and/or antibody-based therapeutics. We hope this new tool will effectively serve this sector.

In addition, we have also included several case reports in this issue, spanning from reporting incidence of synchronous appendiceal tumors and colorectal cancer, management of acute massive pulmonary embolism, Morganella morganii causing persistent urinary tract infections in renal transplant patient, safety evaluation of epidural anesthesia in pregnant patient with severe pulmonary hypertension, utility of cone beam computerized tomography in dentistry and tooth prosthesis, and effective management of urinary bladder stones. We hope you will continue to gain knowledge from these case reports. We have also included a letter highlighting the public health hazards of irresponsible mobile phone use, which in my opinion is not only of health concern but also of social concern and probably if not adequately addressed, may further aggravate the already prevalent burden of cardiovascular diseases and cancer.

JNSBM has continued to progress, and we are delighted to share the first Scimago Journal and Country Rank for JNSBM, which can be accessed at the following link: http://www.scimagojr.com/journalsearch.php?q=21100242246&tip=sid&clean=0. The progress of JNSBM has only been possible due to the authors who have considered submitting their valuable work for publication in JNSBM and the commitment by our reviewer and editorial team who ensure optimal scientific standards in the manuscripts accepted for publication in JNSBM. Thank you all for your continued support for the progress of JNSBM.

Sincerely,

 
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Arun H. S. Kumar



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1 Self-medication practice and associated factors among adult household members in Meket district, Northeast Ethiopia, 2017
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