Coronary event secondary prevention with statins irrespective of LDL-cholesterol.
OBJECTIVE
To review the evidence for statin secondary prevention of coronary artery disease in patients with near-optimal or optimal low-density lipoprotein cholesterol (LDL-C).


METHODS
A MEDLINE search (1966-October 2003) was conducted using the search terms HMG-CoA reductase inhibitor, statins, coronary disease, post-myocardial infarction, and average cholesterol.


RESULTS
Secondary prevention trials enrolling subjects with near-optimal (<130 mg/dL) or optimal (<100 mg/dL) baseline LDL-C were included. Early statin secondary prevention studies suggested attenuated benefit, but more recent trials challenge this finding.


CONCLUSIONS
Statin secondary prevention of coronary artery disease in patients near goal LDL-C is controversial, but recent trial results show promise.
Kerst
Leslie L
LL
The Medical Center of Aurora, 1501 S. Potomac Street, Aurora, CO 80012-5411, USA. leslie.kerst@HealthONEcares.com
Mauro
Vincent F
VF
D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors