[Treatment of hyperlipidemia in patients with ischemic heart disease]

Abstract

Do patients with coronary heart disease benefit from lipid lowering treatment? In the last 20 years clinical research has addressed this question considering 3 different endpoints: clinical events, progression and regression of atherosclerotic plaque, and vascular tone. Eight major secondary prevention trials showed that a 10% reduction in serum cholesterol led to reduction of 15% in the number of all myocardial infarctions. Seven secondary prevention trials based on coronary angiography showed that a 20% serum cholesterol reduction can induce regression and/or reduce progression of plaques in as short as 2 years. In vivo experiments have also shown that coronary spasms are the most common response to various stimulations in hypercholesterolemic individuals; vasodilation is the most common coronary response in subjects with low cholesterol levels.