Lipid lowering agents. How important are they in secondary prevention of coronary heart disease?

BACKGROUND

Coronary heart disease (CHD) is still the single major cause of death in our community despite the dramatic decline in prevalence over the past 20 years or so. The first presentation of CHD in up to 50% of patients is one of the acute coronary syndromes, either acute myocardial infarction or unstable angina. Ninety percent of patients survive the acute episode and remain at high risk of further coronary events.

OBJECTIVE

To review recent evidence regarding the importance of lipid lowering in preventing further coronary events--secondary prevention.

DISCUSSION: The statins ushered in a new era of CHD prevention. Their discovery facilitated an enormous amount of basic research regarding pathogenesis of atherosclerosis and huge clinical trials that demonstrated dramatic reduction of vascular events and improved survival. Lipid lowering is central to secondary prevention in CHD and almost all patients who have had an acute coronary event benefit from statin therapy.