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Current guidelines recommend a target LDL-cholesterol level of less than 100 mg/dL for patients with coronary artery disease. In a multicenter, international, randomized trial, supported by the maker of pravastatin, researchers compared two LDL-lowering strategies: a 100-mg/dL target with 40 mg/day of pravastatin and a 70-mg/dL target with 80 mg/day of atorvastatin. Subjects were 4162 acute coronary syndrome (ACS) patients (mean age, 58; 22% women) with total-cholesterol levels of 240 mg/dL or lower.
Median LDL levels in both groups were 106 mg/dL at randomization (about a week after the ACS event). During 2 years of follow-up, levels declined to 95 mg/dL with standard-dose pravastatin and to 62 mg/dL with high-dose atorvastatin.
Two-year inc…