Intensive Statin Therapy — A Sea Change in Cardiovascular Prevention

In the management of atherosclerotic vascular disease, statin drugs have already surpassed all other classes of medicines in reducing the incidence of the major adverse outcomes of death, heart attack, and stroke. A decade ago, their effectiveness was first demonstrated by the results of the Scandinavian Simvastatin Survival Study (4S), a trial that provided definitive evidence of the benefit of simvastatin, as compared with placebo, in improving survival.1 By 1996, statins were dubbed “miracle drugs,” and their underuse was duly noted.2 Prominent scientists in the field even speculated that heart attacks might be “gone with the century.”3 For the most . . .