Lipid and lipoprotein disorders are well known risk factors for
atherosclerosis and its complications. The level of atherogenic
LDL-cholesterol (LDL-C) is directly related to an increased risk of
occurrence and progression of ischemic heart disease. Epidemiological and
clinical studies have shown that the use of statin therapy to decrease LDL-C
can significantly reduce the incidence of mortality, major coronary events
and the need for revascularization procedures in the different groups of
patients. The findings of a large meta-analysis conducted by the Cholesterol
Treatment Trialists? (CTT) collaborators showed that every 1.0 mmol/l
reduction of atherogenic LDL-C is associated with a 22% reduction in
cardiovascular diseases mortality and morbidity. However, despite the
impressive results of the benefits of statin therapy, the EUROASPIRE study
showed that about 50% of patients with ischemic heart disease did not achieve
target LDL-C levels. According to the new ESC/EAS Guidelines for the
Management of Dyslipidaemias in patients with a very high cardiovascular
risk, treatment goal should be to decrease LDL-C below 1.8 mmol/l or ?50% of
initial values. In the majority of patients that can be achieved by statin
therapy. For this reason an adequate choice of statins is of crucial
importance, whereby the needed reduction in atherogenic LDL-C, after the
identification of its target level based on the assessment of total
cardiovascular risk, can be achieved.
Modern statin therapy in clinical practice: The lower the better
