TY - JOUR T1 - Statins and Mortality in Connective Tissue Diseases: Should We Resume the Cardio-rheumatology Spirit in Our Clinics? JF - The Journal of Rheumatology JO - J Rheumatol SP - 1617 LP - 1619 DO - 10.3899/jrheum.180732 VL - 45 IS - 12 AU - ELISA GREMESE AU - ENRICO DE LORENZIS AU - GIANFRANCO F. FERRACCIOLI Y1 - 2018/12/01 UR - http://www.jrheum.org/content/45/12/1617.abstract N2 - In 1912, Windaus reported that atherosclerotic plaques from aortas of human subjects contained over 30-fold higher concentrations of cholesterol than did normal aortas1, and in 1913 the Russian pathologist Nikolai Anitschkow2, feeding pure cholesterol to rabbits, produced marked hypercholesterolemia and severe atherosclerosis of the aorta. In 1974, Brown and Goldstein discovered the low-density lipoprotein (LDL) receptor and the regulation of cholesterol metabolism in the cells3, and in 1976 Akira Endo4 discovered a fungal metabolite that could block cholesterol synthesis by inhibiting the enzyme hydroxymethylglutaryl CoA. These key steps paved the way to the understanding of LDL cholesterol (LDL-C) levels as one of the primary targets in prevention of ischemic heart attacks and to the discovery of statins as the therapeutic drug capable of reducing the cardiovascular (CV) risk. Since they were first approved in 1987, statins have represented substantial potential for safe, effective, and inexpensive primary prevention of ASCVD (atherosclerotic CV diseases). Among the several risk factors defined in the last 20 years, inflammation and inflammatory biomarkers such as high-sensitivity C-reactive protein (hsCRP) and interleukin 6 have arisen as predictors of future CV events, along with conventional LDL-C or high-density lipoprotein cholesterol (HDL-C). Randomized trial data have also shown that statins reduce not only hsCRP but also CV event rates independently of their effect on LDL-C level. This led to a focus on a further effect of statins: their antiinflammatory effect5,6,7, which appears particularly important in all rheumatic diseases [the chronic arthritides as well … Address correspondence to Dr. G.F. Ferraccioli, Institute of Rheumatology, Università Cattolica del Sacro Cuore, Via Moscati 31, 00168 Rome, Italy. E-mail: gianfranco.ferraccioli{at}unicatt.it ER -