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J Am Coll Cardiol, 2007; 50:1911, doi:10.1016/j.jacc.2007.08.009 (Published online 22 October 2007).
© 2007 by the American College of Cardiology Foundation
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CORRESPONDENCE: LETTER TO THE EDITOR

Reply

Leo Marcoff, MD and Paul D. Thompson, MD, FACC*

* Hartford Hospital, Cardiology, 80 Seymour Street, P.O. Box 5037, Hartford, Connecticut 06102-8000 (Email: pthomps{at}harthosp.org).

Dr. Wolinsky raises an interesting issue. Statins block the rate-limiting enzyme in the mevalonate pathway reducing cholesterol production, but also reduce production of farnesyl and geranylgeranyl pyrophosphate. These molecules participate in post-translational modification or prenylation of the Ras superfamily guanosine triphosphatases or small G proteins. Small G proteins are involved in cell signaling and proliferation. Statin inhibition of these G proteins decreases vascular smooth muscle hypertrophy and proliferation, improves endothelial function, and reduces angiotensin I receptor expression (1). It may also explain the statin antiarrhythmic effect in atrial fibrillation (2).

Coenzyme Q10 (Q10) supplementation should not affect small G protein production since Q10 is not involved in the G protein prenylation process. Furthermore, we recommended that Q10 supplementation be "tested" or "trialed" (3) only in statin myalgic patients to allow ongoing statin treatment.


   References
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 References
 

  1. Liao JK. Effects of statins on 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibition beyond low-density lipoprotein cholesterol Am J Cardiol 2005;96:24F-33F.[ISI][Medline]
  2. Adam O, Frost G, Custodis F, et al. Role of Rac1 GTPase activation in atrial fibrillation J Am Coll Cardiol 2007;50:359-367.[Abstract/Free Full Text]
  3. Marcoff L, Thompson PD. The role of coenzyme Q10 in statin-associated myopathy: a systematic review J Am Coll Cardiol 2007;49:2231-2237.[Abstract/Free Full Text]

Related articles in JACC:

Coenzyme Q10 in Statin-Associated Myopathy
Harvey Wolinsky
JACC 2007 50: 1911. [Full Text]  




This Article
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j.jacc.2007.08.009v1
50/19/1911-a    most recent
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Right arrow Articles by Thompson, P. D.

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