ABSTRACT
The ASTEROID trial (JAMA 2006; 295:1556–1565) showed that very intensive statin therapy with rosuvastatin 40 mg once daily results in highly significant regression of coronary atherosclerosis as assessed by serial intravascular ultrasonography (IVUS). The mean low-density lipoprotein cholesterol (LDL-C) level achieved with this regimen was 61 mg/dL, and the mean high-density lipoprotein cholesterol (HDL-C) level increased by 15%. While the merits of concomitant LDL-C-lowering and HDL-C-raising therapies remain to be determined, the results of the ASTEROID and other recent trials suggest that the optimal strategy for lipid-lowering in patients with coronary artery disease is to try for the lowest LDL-C level that can be attained without adverse effects.
Footnotes
↵* Dr. Sipahi has received an educational grant from Pfizer.
↵† Dr. Nicholls has received lecture honoraria from AstraZeneca and Pfizer.
↵‡ Dr. Tuzcu received grant support from Pfizer and Takeda and lecture honoraria from Pfizer.
↵§ Dr. Nissen has received research support from AstraZeneca, Eli Lilly, Pfizer, Takeda, Sankyo, and Sanofi-Aventis. He has also consulted for a number of pharmaceutical companies without financial compensation. All his honoraria, consulting fees, or other payments from any for-profit entity are paid directly to charity, so that neither income nor tax deduction is received.
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