Evidence for statins and lipid modification

Statins reduce mortality and cardiac events with those with coronary artery disease (4S), but also those with no prior disease and normal LDL (JUPITER). Initiation in acute coronary syndromes reduces mortality, with a trend emerging as early as 30 days (PROVE-IT). However, statins do not appear to affect outcomes in patients with CCF and no other indication for the drugs (CORONA)

Other therapies such as Ezetimibe (ENHANCE) and niacin (AIM-HIGH) have been shown to lower LDL when added to statins, but there is no evidence they improve outcomes.

Topic Therapy group Therapy Trial
Lipids ACS Atorvastatin PROVE-IT
Ezetimibe IMPROVE-IT
CAD (stable) Niacin AIM-HIGH
Rosuvastatin SATURN
Simvastatin 4S
Heart failure Rosuvastatin CORONA
Primary prevention Ezetimibe ENHANCE
Rosuvastatin JUPITER
Primary prevention (T2DM) CARDS CARDS