Therapeutic efficacy of the lipid-lowering armamentarium: the clinical benefits of aggressive lipid-lowering therapy

The American Journal of Medicine
D B Hunninghake

Abstract

Hypercholesterolemia, particularly an elevated level of low-density lipoprotein (LDL) cholesterol, is an unarguably established risk factor for coronary artery disease (CAD). It is equally well established that lowering LDL cholesterol levels will decrease CAD-related morbidity and mortality in patients with established CAD. Although lipid-lowering therapy is known to retard the progression of atherosclerosis in patients with native coronary arteries, its effect in patients with coronary bypass grafts, which are particularly vulnerable to occlusion, is less well understood. Moreover, whereas several major clinical trials have documented the benefits of lowering LDL cholesterol in a variety of patient subpopulations, there has been far less clarity surrounding the question of whether aggressive lowering of LDL cholesterol is of greater benefit than moderate lowering of LDL cholesterol. The Post Coronary Artery Bypass Graft (Post-CABG) trial, a multicenter, randomized, double-blind clinical trial comprising 1,351 patients with elevated levels of LDL cholesterol and a history of bypass surgery was designed to determine whether aggressive lowering of LDL cholesterol levels with therapy based on 3-hydroxy-3-methylglutaryl coenzyme A...Continue Reading

Citations

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