title: The intensive statin therapy myth.
abstract: Statins play an important role in the treatment and prevention of coronary artery disease and atherosclerosis. Currently, however, despite its important qualities, the use of statin therapy in the treatment of CAD patients ranges only between 30 and 60% in Europe, the United States and Israel. A wide gap still exists between the numerous scientific publications demonstrating the beneficial effects of statins and the low rate of implementing the guidelines in practice. A Medline search up to June 2005 on all prospective, double-blind, randomized clinical trials evaluating the impact of intensive statin therapy (any statin dose >40 mg/daily) on clinical outcomes after a 1 year follow-up revealed only eight trials. In all the eight trials, with a follow-up period of 12-60 months, intensive statin therapy was significantly more effective than and at least as safe as placebo or other standard statin regimens. Thus, based on the current evidence-based medicine, intensive statin therapy enables more patients with CAD to achieve the current National Cholesterol Education Program goal for low density lipoprotein, while ensuring a relatively high safety profile.
authors.affiliation: Heart Institute, Sheba Medical Center, Tel Hashomer, Israel. shechtes@netvision.net.il
authors.forename: Michael
authors.initials: M
authors.lastname: Shechter
authors.forename: Roy
authors.initials: R
authors.lastname: Beigel
authors.forename: Shlomi
authors.initials: S
authors.lastname: Matetzky
authors.forename: Dov
authors.initials: D
authors.lastname: Freimark
authors.forename: Pierre
authors.initials: P
authors.lastname: Chouraqui
mesh_terms: D008078:Cholesterol, LDL / Q000187:drug effects*; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000517:prevention & control; D004311:Double-Blind Method; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors