Large amount of evidence has accumulated that lipid-lowering therapy using statins reduce cardiovascular events in patients with coronary artery disease (CAD). These clinical benefits were proportional to the achieved levels of low density lipoprotein cholesterol (LDL-C). Statins are accepted worldwide as the first-line lipid-lowering therapy as guidelines recommend.
Recently, new type of lipid modifying drugs has developed and showed their potential of further reduction of events especially for high-risk patients with CAD in several trials. These results suggested additional benefit beyond maximally tolerated statin therapy in high-risk individuals.
However, there was controversy regarding LDL-C goals and thresholds by intensive lipid lowering therapy using statin, and non-statin strategies in the management of CAD because intensive lipid lowering therapy may not necessarily be applied to all patients.
Here, we will discuss the clinical significance of lipid-lowering therapy for patients with coronary artery disease from the following standpoints: (1) current status of cardiovascular events rate in Japan and Korea, (2) evidence generated from Asian population (3) updated clinical practice and future direction of lipid lowering therapy in patients with coronary artery disease.