Statin: Scoping Review with ☸SAIMSARA

This paper aims to comprehensively synthesize the current evidence on the multifaceted effects of statin therapy, encompassing both its benefits and risks across various physiological systems and patient populations, to identify key clinical implications and future research directions. The review utilises 4734 original studies with 141,699,669 total participants (topic deduplicated ΣN). Across this evidence map, statin therapy most consistently aligns with improved cardiovascular outcomes in high-risk settings, including signals supporting reduced major adverse cardiovascular events and mortality, while also highlighting recurrent safety trade-offs such as higher risk of incident type 2 diabetes and increases in lipoprotein(a). Beyond lipid lowering, the mapped literature repeatedly points to pleiotropic pathways—anti-inflammatory and plaque-stabilizing effects—appearing across domains such as heart failure, stroke, and infectious/critical illness outcomes. At the same time, associations with musculoskeletal symptoms and other system-specific adverse outcomes underscore the need for individualized risk–benefit discussions and monitoring, particularly in susceptible subgroups. Interpretation is limited by the scoping design and the LLM-assisted classification workflow, which prioritize breadth over causal certainty and may introduce misclassification. Clinically, the map supports early and sustained statin use where cardiovascular risk is high while motivating research to better stratify diabetes risk and to clarify the clinical significance of statin-associated lipoprotein(a) increases.