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Editor's Correspondence
September 25, 2000

Underutilization of Lipid-Lowering Therapy in Coronary Artery Disease

Arch Intern Med. 2000;160(17):2683-2684. doi:

Miller et al1 found relatively low treatment rates of hyperlipidemia among patients with coronary artery disease in the Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT). Several large prospective placebo-controlled clinical trials with statins showed benefit in the risk of recurrent coronary events in patients with established coronary heart disease.2-4 In addition to lowering low-density lipoprotein (LDL) cholesterol levels, statin therapy appears to exhibit pleiotropic effects on many components of atherosclerosis, including plaque thrombogenicity, cellular migration, endothelial function, and thrombotic tendency.5 Some studies have demonstrated a high prevalence of modifiable risk factors in coronary heart disease as well as considerable potential to reduce the risk of a further major ischemic event in patients.6-8 In Spain, the PREVESE study6 (secondary prevention of myocardial infarction in Spain) found a very small percentage of lipid-lowering prescription (6.7%) at discharge among 1242 patients with myocardial infarction.

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