Statins--is there potential for uncovering new benefits (or detriments)?

Despite over 20 years of clinical use and 15 years of clinical trial data, we still do not have a complete understanding of the mechanisms of action or full utility of statins as a class of drugs. The possibility of their use as a treatment for prevention of peri-operative morbidity and mortality is one of the newest indications being explored for this class of drugs. Issues regarding drug dosing and timing may rely on being able to elucidate and separate potential pleiotropic actions from lipid-lowering actions to identify the optimal benefit of these drugs in the peri-operative setting. Careful consideration of these two actions need to be considered in the design of adequately powered clinical trials to test the potential utility and safety of using statins in the peri-operative setting.