Background: Atherosclerosis is a systemic, progressive lipid-driven inflammatory disease of the arterial
vascular wall leading progressively to plaque development. The vulnerable plaque, the one considered to be
the leading cause of cardiovascular events seems to exhibit a large and soft lipid-rich necrotic core covered by a
thin and inflamed fibrous cap. Statin treatment is considered as one of the most effective methods for vulnerable
plaque stabilization, currently being the principal drug in primary and secondary prevention of cardiovascular
Objective: We sought to evaluate the beneficial effect of statins on biological processes involved in the evolution
of vulnerable plaques
Method: We performed a systematic review of the literature searching MEDLINE via Pubmed for all experimental
and human studies implementing statins in vulnerable plaque.
Results: Statins seem to have a beneficial role in plaque stabilization and patient outcome. It seems that this effect
is mediated by improving endothelial function, decreasing oxidative stress and inflammation, reducing inflammatory
activation and inhibiting thrombogenic response. Although these data are quite promising, it remains to be
determined the extent of a potent benefit of the pleiotropic effects of statin therapy in clinical setting.
Conclusion: Prospective randomized trials should be conducted in order to further elucidate differences among
type and dose of statin therapy, duration of treatment and association with LDL levels and clinical outcome.