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Published on: November 10, 2017
The use of statins in pediatrics: knowledge base, limitations, and future directions
Brook Belay1, Peter F Belamarich, Catherine Tom-Revzon
1Department of Pediatrics, Temple University Children's Medical Center, 3509 N Broad St, Philadelphia, PA 19140, USA. brook.belay@tuhs.temple.edu
Insights
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) effectively prevent heart disease in adults. This review explores their use, benefits, and limitations in children, suggesting future applications for high-risk youth.
Area of Science:
- Cardiology
- Pharmacology
- Pediatrics
Background:
- Statins are widely used in adults to reduce cardiovascular morbidity and mortality.
- Pediatric use of statins is currently limited.
- Understanding the cholesterol hypothesis is key to statin application.
Purpose of the Study:
- To review the established knowledge of statin use in adults and children.
- To examine the efficacy of statins in primary and secondary cardiovascular event prevention.
- To discuss statin toxicities and pediatric limitations.
Main Methods:
- Literature review focusing on statin efficacy and safety.
- Analysis of statin use in adult and pediatric populations.
- Evaluation of statins in conjunction with noninvasive atherosclerosis assessment.
Main Results:
- Statins are proven effective in reducing cardiovascular events in high-risk adults.
- Current pediatric data on statin efficacy and safety is less extensive.
- Noninvasive imaging can aid in assessing atherosclerotic burden.
Conclusions:
- Further research is needed to optimize statin use in children.
- Targeted statin therapy may benefit high-risk pediatric populations.
- Advancing pediatric statin use requires careful consideration of benefits and risks.
Abstract:
The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, effectively reduce coronary morbidity and mortality in high-risk adults. They are also some of the most widely prescribed medications in the United States. Their use in pediatrics, however, remains circumscribed. In this article we review the cholesterol hypothesis and focus on the knowledge base of the use of statins in adults and children. We pay particular attention to the known effects of statins in primary and secondary prevention of cardiovascular events. The toxicities of statins and their limitations in pediatrics are then considered. The use of statins in conjunction with noninvasive modalities of assessing atherosclerotic burden are also reviewed. Finally, we suggest methods to advance the use of statins in childhood that introduce their potential benefits to those individuals at highest risk for future events.
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