Statins for acutely hospitalized patients: randomized controlled trials are long overdue

From the earliest studies of statins for control of plasma cholesterol, observations have been made that the reductions in mortality observed occurred in a manner seemingly independent from what could be anticipated from cholesterol lowering alone. Over the last decade, the pleiotropic effects of statins have been increasingly elucidated. Perhaps most intriguing are the effects statins appear to have on the immune system, especially the modulation of diffuse or systemic inflammation. There is a growing body of observational literature suggesting that statins can actually reduce hospital mortality through mechanisms far beyond those that can be explained by reductions in cardiovascular events.