Event reduction: revisiting why we treat with statins and harnessing current evidence towards optimal therapy.
BACKGROUND
Statins are widely accepted as the drugs of choice for achieving increasingly stringent low-density lipoprotein cholesterol (LDL-C) goals for dyslipidemic patients. However, when making treatment decisions, outcomes data from clinical trials are of greater importance than LDL-C-lowering ability.


METHODS
This review will provide an update on current lipid treatment guidelines in the context of statin trial evidence, with particular focus on the incremental benefit of more potent statin therapy compared with lower doses. The discussion will also address combination therapy, statin safety, goal attainment and treatment adherence. MEDLINE searches (1966 to July 2010) were performed.


RESULTS
The reader will gain a comprehensive review of the evidence base for statin therapy and an appreciation of other issues that affect treatment choice.


CONCLUSIONS
It is important to remember why we need to partner with our patients: to ensure that they are established on, and continue to adhere to, their appropriate evidence-based statin dose with a goal of achieving lipid targets, but more importantly to prevent cardiovascular disease-related morbidity and mortality. We treat patients to reduce clinical cardiovascular events, not just to control lipids and other important risk factors.
Medical University of South Carolina, SC College of Pharmacy, Department of Clinical Pharmacy and Outcome Sciences, 280 Calhoun Street, Charleston, SC 29425, USA. weartcw@musc.edu
Charles Wayne
CW
Weart
Richard J
RJ
Hogan
D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D011322:Primary Prevention / Q000379:methods*
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors