August 2012 Br J Cardiol 2012;19:126–33 doi:10.5837/bjc.2012.024
Paul N Durrington
Introduction Statins have proved beyond doubt the relevance of reducing low-density lipoprotein (LDL) in atherogenic cardiovascular disease (CVD), with the risk of a new CVD event reducing by one-fifth for each 1 mmol/L decrease in LDL-cholesterol (LDL-C) achieved.1 A typical patient experiencing an acute coronary event in the UK will do so with LDL-C of 3.8 mmol/L.2 Thus, introducing a statin to achieve a target of just under 2 mmol/L will decrease the risk of a future event by no more than 40%. Unlike more uncommon patients with much higher LDL-C levels, such as those with heterozygous familial hypercholesterolaemia,3 the pre-treatment LDL-
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