Hydroxyglutaryl coenzyme A (HMG-CoA) reductase inhibitors are a new class of lipid-lowering drugs, and they have a market share of more than 10 billion US dollars in the current pharmaceutical field. They can selectively inhibit the rate-limiting enzyme HMG-CoA reductase in cholesterol synthesis in the liver, reduce liver lipoprotein production, and increase the expression of low-density lipoprotein (LDL) cholesterol receptors, thereby reducing plasma cholesterol levels. They can also significantly reduce very low-density lipoprotein (VLDL) and triglycerides, and increase anti-atherosclerotic high-density protein (HDL), preventing atherosclerosis and coronary heart disease.
Ethyl (R)-(-)-4-cyano-3-hydroxybutyate is an important intermediate for the synthesis of HMG-CoA reductase inhibitors. If it is used as a raw material, synthetic atorvastatin is mainly used for the treatment of hypercholesterolemia and mixed hyperlipidemia, coronary heart disease and stroke.
