Treatment of patients with mild to moderate hypercholesterolemia: Lipoprotein and Coronary Atherosclerosis Study (LCAS)

Although the benefit of lipid lowering therapy in patients with severely elevated LDL cholesterol has been established in numerous clinical trials, the effect of lipid lowering therapy in patients with mild to moderate LDL cholesterol elevations is not well studied. LCAS used quantitative coronary angiography to evaluate the effect of lipid lowering with fluvastatin on CAD progression in patients with CAD and mildly to moderately elevated LDL cholesterol. At 2.5 year follow up, LDL cholesterol was reduced by 23.9% in all fluvastatin patients. Analysis of the primary end point, change in MLD from baseline to 2.5 years, indicated significantly less progression with fluvastatin: 0.028 ± 0.021 mm in all fluvastatin patients vs. 0.100 ± 0.022 mm in all placebo patients (p=0.005). LCAS provides additional evidence that statins benefit patients whose LDL cholesterol is mildly to moderately elevated and that different statins have a similar beneficial effect on CAD progression.