, Volume 13, Issue 1, pp 4-8

Statins in Combinations: From ARBITER-6 HALTS to ACCORD—What Works?

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Taylor AJ, Villines TC, Stanek EJ, et al.: extended-release niacin or ezetimibe and carotid intima-thickness. N Engl J Med 2009, 361:2113–2122.

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Introduction

Statin therapy in both primary and secondary prevention studies has been shown to be effective in significantly reducing cardiovascular events [1]. Reductions in low-density lipoprotein cholesterol (LDL-C) clearly lead to reductions in cardiovascular events, yet a significant number of events still remain in those treated. Although statins are the cornerstone for lipid medication interventions, other lipid-modifying medications such as niacin [2] and cholestyramine [3], as well as non-medication interventions such as lifestyle changes [4] and intestinal bypass [5], have also resulted in positive clinical outcomes. For most of these trials, the therapeutic target has been a reduction of LDL-C; however, even with more aggressive approaches cardiovascular events continue to occur. This residual risk may be related t