LDL-cholesterol: a risk factor for coronary artery disease--from epidemiology to clinical trials.

Discussion of potential strategies to modify lipids and lipoproteins other than low density lipoproteins (LDLs) should first recognize the convincing evidence in favour of the identification and aggressive treatment of elevated LDL cholesterol (LDL-C) levels in patients with established cardiovascular disease. Elevated LDL-C level is one of the few risk factors for which there is evidence of involvement in every pathophysiological step of the development of cardiovascular disease. Longitudinal studies have established the role of LDL-C as a risk factor for cardiovascular disease incidence, recurrence and fatal outcome. Clinical trials and economic analyses have proven that aggressive treatment of elevated LDL-C in patients at high risk can prevent cardiac events with excellent cost effectiveness.