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T he number of significant developments in the years since the first version of this review has made necessary an update about the evolving role of 3-hydroxy-3methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, or statins, in the management and prevention of cardiovascular disease. 1 Two contrasting events have dominated the statin field in the last 3 years.First, the withdrawal of cerivastatin in 2001 reignited the issue of statin safety.Second, the efficacy and safety of statins in both the primary and secondary prevention of cardiovascular disease in diverse patient populations have helped shape the most recent set of guidelines from the National Cholesterol Education Program (NCEP). 2 The NCEP's Third Adult Treatment Panel (ATP III) forms the basis for contemporary lipid management.However, very recent trials suggest that even lower LDL cholesterol (LDL-C) targets may be indicated in high-risk patients.Improved understanding of the metabolism, safety, and clinical effects of this class of drugs has placed the statins at the forefront of drug strategies to treat dyslipidemia.
Vaughan et al. (Mon,) studied this question.
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