Reducing morbidity and mortality in high risk patients with statins.
Residual coronary heart disease remains a significant problem even after adequate statin therapy for cardiovascular risk reduction as currently recommended by the Adult Treatment Panel III (ATP-III) of the National Cholesterol Education Program (NCEP). This is particularly true for the high risk patients as defined by ATP-III that includes those patients who have a greater than 20% 10-year risk of adverse cardiac events. For such patients the current goal of a low-density lipoprotein cholesterol (LDL-cholesterol) maintenance level of < or =100 mg/dL plasma appears to be suboptimal. Accumulating data from several recent randomized studies of more aggressive LDL-cholesterol reduction to levels below 70 mg/dL in the high risk patients favor acceptance of such a new lower target for LDL-cholesterol using more intensive statin therapy which would affect the treatment strategy for patients with coronary heart disease pre-percutaneous intervention, metabolic syndrome, diabetes mellitus, congestive heart failure, cerebrovascular disease and chronic kidney disease.
Singh
Vibhuti
V
University of South Florida College of Medicine, Suncoast Cardiovascular Center, 601 7th Street South, St. Petersburg, FL 33701, USA. vsingh@health.usf.edu
Deedwania
Prakash
P
D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy; D008078:Cholesterol, LDL / Q000187:drug effects*; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D048909:Diabetes Complications / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy; D008659:Metabolic Diseases / Q000150:complications / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin