Statin Treatment and the Alterations in the Platelet Lipidome: What Is the Impact of Lipid Profile on Thrombosis?

The Association of Lipid and Thrombosis: Current Evidence It is well known that low-density lipoprotein (LDL) plays important roles in thrombosis[ 1 ] such as major adverse cardiovascular events (MACEs) including cardiovascular death, myocardial infarction, and ischemic stroke. A large body of clinical evidence has clearly shown that statin treatments lower the risk of thrombosis-related MACE, especially in arterial diseases.[ 2 ] Recent clinical studies testing the efficacy of nonstatin lipid-lowering agents have also shown that these medications further reduce the risk of thrombosis-related MACE and have supported the idea of the so-called “lower the better” strategy for LDL.[ 3 ] [ 4 ] However, there is still an ongoing debate on whether statin has a pleiotropic effect over simple LDL reduction. In contrast to the success in targeting LDL, clinical trials targeting lipids other than LDL have largely failed to show efficacy in preventing thrombosis. These results suggested that simple lowering/increasing of a lipid family other than LDL have limited effect for thrombosis-related MACE. However, lipids are an important component in the cell membrane and have complex biological functions. It could have complex associations with the progression of atherosclerosis and thrombosis-related MACE that are not reflected in simple lowering/increasing. There may also be functionally synergistic actions between antiplatelet and lipid-lowering drugs, which may reduce the incidence of atherothrombotic vascular events, as recently reviewed.[ 5 ] Publication History Received: 06 March 2023 Accepted: 07 March 2023 Accepted Manuscript online: 13 March 2023 Article published online: 03 April 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany