Missed statins for 2 days
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Impact of Missing Statins for 2 Days: Key Insights
Short-term Statin Discontinuation and Endothelial Progenitor Cells (EPCs)
Type 2 Diabetes and EPCs: In patients with type 2 diabetes (T2D), short-term discontinuation of statins for 5 days has been shown to increase the levels of endothelial progenitor cells (EPCs) without causing an inflammatory rebound. This suggests that a brief interruption in statin therapy can enhance vascular repair mechanisms in T2D patients by increasing circulating EPCs and functional proangiogenic cells.
Lipid Profile Changes: During the 5-day statin discontinuation, there was a noticeable increase in total and LDL cholesterol levels. However, no significant changes were observed in inflammatory markers such as hsCRP, VEGF, SDF-1α, and G-CSF, nor in monocyte-macrophage polarization.
Statin Withdrawal and Stroke Protection
Stroke Protection in Mice: In a study involving mice, the withdrawal of statin treatment led to a rapid loss of stroke protection. Mice treated with atorvastatin for 14 days showed a 40% reduction in stroke damage, but this protection was lost within 2 to 4 days after stopping the treatment.
Endothelial Nitric Oxide Synthase (eNOS) Regulation: Statins upregulate eNOS, which is crucial for vascular function. Upon withdrawal, there was a significant downregulation of eNOS in both the aorta and brain vasculature, leading to impaired vascular function.
Thrombus Formation: Statin treatment reduced thrombus formation, but this protective effect was lost shortly after discontinuation. The withdrawal resulted in increased expression of RhoA GTPase and platelet activation markers, which are associated with thrombus formation.
Conclusion
Missing statins for 2 days can have significant effects on vascular health and stroke protection. In T2D patients, short-term discontinuation may increase EPCs and enhance vascular repair without causing inflammation. However, in the context of stroke protection, the withdrawal of statins can rapidly negate their protective benefits, highlighting the importance of consistent statin therapy for maintaining vascular health and preventing thrombotic events.
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