RESULTS OF RECENT LARGE CHOLESTEROL - LOWERING TRIALS AND IMPLICATIONS FOR CLINICAL MANAGEMENT

Three recent large clinical trials-the West of Scotland Coronary Preve ntion Study, the Scandinavian Simvastatin Survival Study, and the Chol esterol and Recurrent Events Trial-have all confirmed that cholesterol lowering with HMG-CoA reductase inhibitors is safe and effective ther apy to prevent an initial recurrent coronary event in patients at high risk for coronary heart disease. However, a number of questions relat ed to the treatment of lipid disorders and risk reduction for coronary heart disease remain, including the cholesterol concentration at whic h treatment would best be initiated, the optimal cholesterol reduction or goal to be attained, and the mechanisms by which HMG-CoA reductase inhibitors reduce the risk for clinical events.