Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Athyros and colleagues describe the results of the GREACE study, which demonstrated that a small increase in levels of HDL-C independently predicted the clinical benefit observed during administration of atorvastatin in patients with established coronary heart disease.1 This observation highlights a number of important points. Their findings provide further evidence to support the concept that small increases in levels of HDL-C are clinically important. We believe that the beneficial effect of statin therapy is likely derived from several properties beyond the ability of these drugs to lower levels of LDL-C. The findings described by the GREACE investigators also represent an example of the complementary observations between clinical outcomes trials and imaging studies that measure the rate of atheroma progression as assessed by intravascular ultrasound.
Nicholls SJ, Tuzcu EM, Nissen SE. Statins and Regression of Coronary Atherosclerosis—Reply. JAMA. 2007;297(20):2197. doi:10.1001/jama.297.20.2197-b