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Published Online, 30 April 2004, www.theannals.com, DOI 10.1345/aph.1D166.
 The Annals of Pharmacotherapy: Vol. 38, No. 6, pp. 1060-1064. DOI 10.1345/aph.1D166
© 2004 Harvey Whitney Books Company.
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DRUG INFORMATION ROUNDS

Coronary Event Secondary Prevention with Statins Irrespective of LDL-Cholesterol

Leslie L Kerst, PharmD

Pharmacy Practice Resident, The Medical Center of Aurora, Aurora, CO

Vincent F Mauro, PharmD FCCP

Associate Professor of Clinical Pharmacy, College of Pharmacy, University of Toledo; Adjunct Associate Professor of Medicine, Department of Medicine, Medical College of Ohio, University of Toledo

Reprints: Leslie L Kerst PharmD, The Medical Center of Aurora, 1501 S. Potomac St., Aurora, CO 80012-5411, fax 303/873-5920, leslie.kerst{at}HealthONEcares.com

OBJECTIVE: To review the evidence for statin secondary prevention of coronary artery disease in patients with near-optimal or optimal low-density lipoprotein cholesterol (LDL-C).

DATA SOURCES: A MEDLINE search (1966–October 2003) was conducted using the search terms HMG-CoA reductase inhibitor, statins, coronary disease, post-myocardial infarction, and average cholesterol.

DATA SYNTHESIS: Secondary prevention trials enrolling subjects with near-optimal (<130 mg/dL) or optimal (<100 mg/dL) baseline LDL-C were included. Early statin secondary prevention studies suggested attenuated benefit, but more recent trials challenge this finding.

CONCLUSIONS: Statin secondary prevention of coronary artery disease in patients near goal LDL-C is controversial, but recent trial results show promise.

Key Words: HMG-CoA reductase inhibitors, myocardial infarction, secondary prevention, statins

Published Online, April 30, 2004. www.theannals.com, DOI 10.1345/aph.1D166


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