Statin The Most Controversial Drug Of Our Times: A Commentary

Cardiovascular disease (CVD) is the leading cause of death worldwide.Atheroscelerotic cardiovascular disease(ASCVD) is also a leading cause of death and disability. Statins can reduce the risk and prevent heart diseases. One of the best studied medication and in randomized controlled trials have been proven to reduce the no of Heart attacks and stroke even in individuals with normal cholesterol levels. A small no of individuals may develop Diabetes on statins.The benefit from lowering the risk of death, heart attack and stroke are likely to outweigh the development of diabetes in those individuals. The beneficial effects of statins may not only be due to the cholesterol lowering effects but also due to cholesterol independent or pleiotropic effects. These benefits include endothelial protective functions, enhancing stability of atherosclerotic plaques and inhibiting vascular smooth muscle proliferation and platelet aggregation. It remains to be seen to what extent these pleiotropic benefits of statin therapy can be attributed beyond cholesterol lowering.

Study of clinical parameters in chronic periodontitis.

Back ground: Periodontitis is a chronic inflammatory disease, causes changes in peripheral blood markers with slight abnormal lipid profile including the production of different enzymes that are released by stromal, epithelial or inflammatory cells. These changes reflect metabolic changes in the gingival and periodontium in inflammation. Design of study: This important cohort study includes 54 subjects as chronic periodontitis patients along with 26 healthy age matched controls of both sexes, In this study, different peripheral blood markers (Neutrophils,WBC,RBC,Thrombocytes and Hb%), major inflammation markers (plasma Homocysteine, CRP),Total lipid profile (Cholesterol, TGL,HDL, LDL) and salivary enzymes (CK, LDH,AST, ALT, ALP, ACP and GGT) are studied to evaluate diagnosis, prognosis and therapeutic effects in this disease. Results: Due to stasis of blood stream in periodontitis causes margination of central blood stream cells and finally there will be significant correlation in Neutrophils (r=0.342), WBC(r=0.431),thrombocytes(r=0.216),RBC(r=-0.183)Hblevel(r=-0.162).Inflammation markers and total lipid profile also show significant positive correlation: plasma homocystein (r=0.763),C-reactive protein(r=0.842),Total cholesterol,TGL,LDL (r=0.134,0.529,0.293) except HDL(r= -0.734). Salivary enzymes (CK-0.923, LDH-0.314, AST-0.841, ALT-0.832,ALP-0.782, ACP-0.826 and GGT-0.794) with gingival index and pocket depth. Conclusion: By studying this simple, economical clinical parameters we can assess the damage of periodontal tissue and useful in prediction of future risk of atherosclerosis in chronic periodontal patients.