STATINS IN CARDIOVASCULAR PREVENTION: FROM DISCOVERY TO CLINICAL EVIDENCE

Abstract

Cardiovascular disease remains the leading cause of mortality worldwide, with elevated low-density lipoprotein cholesterol (LDL-C) recognised as a primary modifiable risk factor. The pharmacological management of dyslipidaemia underwent a fundamental transformation following the discovery of compactin by Akira Endo in 1973 through systematic screening of fungal cultures, an observation that established the foundation for the entire statin drug class. Lovastatin, the first commercially approved HMG-CoA reductase inhibitor, received FDA authorisation in 1987 and was subsequently followed by pravastatin, simvastatin, fluvastatin, atorvastatin, rosuvastatin, and pitavastatin, each generation characterised by progressively greater potency, more favourable pharmacokinetic profiles, and improved metabolic tolerability.