Atherogenesis has been traditionally viewed as a metabolic disease representing arterial obstruction by fatty deposits in its wall. Today, it is believed that atherogenesis involves highly specific biochemical and molecular responses with constant interactions between various cellular players. Despite the presence of inflammatory reaction in each and every step of atherosclerosis from its inception to terminal manifestation, the cause–effect relationship of these 2 processes remains unclear. In this article, we have attempted to review the role of inflammation in the development of atherosclerosis and in its major complication—coronary heart disease.

Advances in Dyslipidemia Do we need to treat patients with heart failure with statins?Sadip Pant, Guru S Gurumurthy, Abhishek Deshmukh & Jawahar L MehtaSadip PantSadip Pant is currently a Resident Physician at the University of Arkansas for Medical Sciences (USA). His research focus on cardiovascular disease is mainly of clinical and translational type. He has published multiple original and review papers in the field of cardiovascular medicine.Search for more papers by this author, Guru S GurumurthyGuru S Gurumurthy is currently a Resident Physician at the University of Arkansas for Medical Sciences. He has a keen interest in clinical cardiology. He is a member of the American College of Physicians.Search for more papers by this author, Abhishek DeshmukhAbhishek Deshmukh is currently a fellow in cardiology at the University of Arkansas for Medical Sciences. His clinical research is well known in the field of cardiology. He serves as an independent reviewer in many national and international journals.Search for more papers by this author & Jawahar L MehtaJawahar L Mehta is a well-published Clinician–Scientist, with his major interests being lipids and the rennin–angiotensin system in ischemic heart disease. He serves as Professor of Medicine and Physiology at the University of Arkansas for Medical Sciences and holds the Stebbins Chair in cardiovascular research.Search for more papers by this authorPublished Online:18 Dec 2013https://doi.org/10.2217/fmeb2013.13.14AboutSectionsView ArticleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInRedditEmail View chapterAbstract: Statin therapy is widely used for secondary prevention of atherosclerotic cardiovascular disease. Statin studies and therapy indications have covered many cardiovascular and noncardiovascular disease processes in the recent past, and heart failure (HF) is no exception. Drug therapy to prolong survival or reduce hospitalization for HF has been one of the challenges of the past 20 years. Numerous clinical trials have examined the effects of a variety of drugs on survival in HF. Time and again, observational studies were thought to point towards beneficial effects of statins. The hypothesis behind such research was built on the fact that coronary artery disease (CAD) is the leading cause of HF. Therefore, statins frequently got supplemented into the regimens of patients with HF. The ‘ischemic burden reduction’ concept was complemented by the multiple nonlipid-lowering benefits of the statins observed in animal models and clinical studies, the so-called ‘pleiotropic effects’. However, important uncertainties remained regarding how much benefit would be garnered by the untested strategy of initiating statins in HF. In order to address this issue directly, two major randomized trials, CORONA and GISSI-HF, were recently conducted. Both the trials failed to demonstrate a reduction in mortality and cardiovascular events with statin therapy. Furthermore, it has now been observed that low serum cholesterol is associated with worse outcomes in HF. Finally, impairment of mitochondrial oxidation pathways, through CoQ depletion, adverse effects of statins, cost and its drug interaction, added to the problem. It remains unanswered if the progression of CAD contributes to the progression of left ventricular dysfunction and if it would be modulated by statin therapy. Pending further substantiation of the proof, using the current evidence to prescribe statins would expose many people with HF to the potential harms and costs of lifelong statin therapy and is, therefore, best avoided. However, their important role in low-density lipoprotein (LDL) cholesterol reduction for compelling indications cannot be ignored. References1 Pietro Maggioni A . Debate: should statin be used in patients with heart failure? Curr. Control. 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