Achieving greater reductions in cardiovascular risk: lessons from statin therapy on risk measures and risk reduction.
Reductions in low-density lipoprotein (LDL) cholesterol with statins have been shown to significantly reduce risk of coronary heart disease (CHD) in the primary- and secondary-prevention settings. Benefit has been observed even in high-risk patients whose baseline LDL cholesterol levels were below the drug initiation levels recommended by current treatment guidelines. Levels of non-high-density lipoprotein cholesterol or total apolipoprotein B more accurately reflect circulating levels of atherogenic particles than does LDL cholesterol concentration, and may provide a surrogate marker that correlates better to CHD event reduction after statin therapy than LDL cholesterol level. More effective lipid-lowering therapy than that currently practiced may be needed in many patients to achieve optimal CHD risk reduction.
Ballantyne
Christie M
CM
aBaylor College of Medicine and the Methodist DeBakey Heart Center, Houston, Tex 77030, USA. cmb@bcm.tmc.edu
D001055:Apolipoproteins B / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000517:prevention & control*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood*; D012016:Reference Values
D001055:Apolipoproteins B; D015415:Biomarkers; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D008074:Lipoproteins