Coronary Artery Disease, Hyperlipidemia, Microorganisms and Statins.

ABSTRACT

Coronary artery disease is a leading cause of death in the world. İnflammation has an important role in the pathogenesis of atherosclerosis. We have known that microorganisms are responsible in atherosclerosis and since they have found in atherosclerotic plaques. Many studies on the effectiveness of statins in atherosclerosis treatment support that besides the antilipidemic activity of the statins, their pleiotropic activities (regulating endothelial function, stabilization of the plaque, decreasing oxidative stress, anti-inflammatory activity, decreasing thrombogenic response to inflammation and immunomodulatory activity) have an important role in their effectiveness on mortality and morbidity. As a result, it has been understood that microorganisms have an important role in the etiology of coronary artery occlusion. It has been found that hyperlipidemia is an early defense system against microbial damage of the vessel wall. Suppression of hyperlipidemia-related atherosclerosis or atherosclerotic plaque by drugs or methods not having antimicrobial activity is thought to trigger sudden vessel occlusion. Causes of sudden death associated with coronary artery and other forms of atherosclerosis have still not been fully elucidated. This study proposes that hyperlipidemia and atherosclerosis develop as a defense reaction to damage caused by micro-organisms in the coronary arteries. It also proposes that the treatment of atherosclerosis-associated subtotal obstruction of the coronary artery with hypolipidemic drugs exhibiting no antimicrobial activity, or in other ways (extreme weight loss in a short period of time), may cause sudden death.