Statins as a Primary Prevention: Which One is Most Effective? A Systematic Review and Meta-Analysis

The metabolic pathway that produces cholesterol and other isoprenoids is known as the mevalonate pathway. The rate-controlling enzyme of this pathway is 3-hydroxy-3-methyl-glutaryl-CoA reductase or HMG-CoA reductase (HMGCR). This rate-controlling step in the biosynthesis of isoprenoids and sterols can berestricted by the use of statins.

This step involves the four-electron reductive deacylation of HMGCoA to CoA and mevalonate. It is catalyzed by HMGR in a reaction that proceeds as follows:

(S) HMG CoA + 2 NADPH + 2 H+ ⇒ (R)

Mevalonate + 2 NADP+ + CoASH

Where NADP+ is the oxidized form of nicotinamide adenine dinucelotide, NADPH is the reduced form of NADP+, and CoASH is the reduced form of CoA. One specific intervention for the use of HMG-CoA reductase inhibitors or statins is the potent effect on cholesterol.  Read more...............