Cardiology Division, Department
of Medicine, San Francisco General Hospital, San Francisco,
California 94110, USA.
To date, 5 major randomized, placebo-controlled
statin trials--the Scandinavian Simvastatin Survival
Study, West of Scotland Coronary Prevention Study,
Cholesterol and Recurrent Events trial, Long-term
Intervention with Pravastatin in Ischaemic Disease,
and Air Force/Texas Coronary Atherosclerosis Prevention
Study--have convincingly shown that total mortality
and major coronary events can be significantly reduced
by lowering levels of low-density lipoprotein cholesterol
(LDL-C) with statin therapy. These results were achieved
in a broad range of patients including those with
and without a history of coronary artery disease and
with elevated or average LDL-C levels. The results
also support the large body of epidemiologic evidence
demonstrating that the lower the cholesterol level,
the lower the cardiovascular risk. Evidence now substantially
supports the urgency of physicians to aggressively
target the lowering of LDL-C levels for the primary
and secondary prevention of coronary disease.
