Implications of the atorvastatin versus revascularization treatment (AVERT) study for the clinician.
The underlying disorder in the vast majority of cases of cardiovascular disease is atherosclerosis, for which low-density lipoprotein cholesterol is recognized as a major risk factor. Data from epidemiologic studies have suggested that lower cholesterol levels are associated with a lower overall risk of morbidity and mortality due to coronary heart disease. Numerous clinical trials with lipid-lowering agents support these epidemiologic data. Of these, studies with the HMG-CoA (3-hydroxy 3-methylglutaryl coenzyme A) reductase inhibitors, or statins, have shown the greatest lipid-lowering effects. Data from recent trials such as the Atorvastatin Versus Revascularization Treatment contribute to a growing body of evidence that suggests that aggressive reduction of cholesterol can yield additional clinical benefits above and beyond that observed with less robust treatment regimens. Aggressive cholesterol-lowering strategies have the potential therefore to have a significant impact on levels of atherosclerotic disease throughout the westernized world. Such effects argue in favor of renaming the entire class of drugs as anti- atherosclerotic rather than lipid-lowering agents.
Eisenberg
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Foothill Cardiology/California Heart Care, 2601 West Alameda Avenue, Suite 304, Burbank, CA 91505, USA. daniele9@aol.com
D015906:Angioplasty, Balloon, Coronary; D000069059:Atorvastatin; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000601:surgery; D003327:Coronary Disease / Q000188:drug therapy* / Q000601:surgery*; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use*; D016896:Treatment Outcome
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D011758:Pyrroles; D000069059:Atorvastatin