The value of lipid lowering in patients with coronary heart disease
Journal of Clinical and Basic Cardiology 2001; 4 (1): 31-34
Keywords: Koronare Herzkrankheit, Koronarintervention, Lipidsenkung, Statin, CHD, coronary heart disease, coronary intervention, lipid lowering, Statin
Atherosclerosis is by far the most frequent cause of coronary heart disease (CHD). Five large studies have provided unequivocal evidence that lipid lowering by statins significantly reduce the incidence of CHD endpoints. New insights in pathophysiology show that statin therapy reduces progression of atherosclerosis and leads to plaque stabilization as well as a reduced plaque thrombogenicity. In CHD patients treatment with statins may prevent plaque rupture of atherosclerotic lesions and therefore reduce the occurrence of acute coronary syndromes. Patients with haemodynamically relevant stenosis and angina interfering with quality of life and patients who have less exercise tolerance may be regarded as candidates for coronary intervention. In these patients aggressive lipid-lowering may complement angioplasty by stabilizing untreated lesions. According to the guidelines of the National Cholesterol Educational Program LDL-cholesterol of no more than 100 mg/dl is considered optimal in patients with CHD or other atherosclerotic diseases. The results of the Atorvastatin Comparative Cholesterol Efficacy and Safety Study demonstrate that in a majority of patients (76.3 %) these target levels of LDL-cholesterol can be reached by using an aggressive lipid-lowering therapy with statins. J Clin Basic Cardiol 2001; 4: 31-34.