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[Statins in secondary prevention of cardiovascular risk]

Statins in secondary prevention of cardiovascular risk. After 25 years of clinical trial Statin efficacy is well established in secondary prevention of cardiovascular risk data. The recent guidelines recommend the use of high-intensity statin therapy in order to reach an LDL-cholesterol (LDL-c) concentration under 0.70g/L. Nevertheless, the effectiveness of this strategy remains unclear. Indeed, the number of patients to treat to avoid one cardiovascular event increases while the LDL-c threshold is decreased. Statin efficacy depends on different factors including inter-individual statin response, tolerance and therapeutic observance certainly improved is secondary prevention compared to primary prevention. Finally, the optimal LDL-c target to reach beyond 0.70 g/L remains unknown and the development of new but expansive treatments will bring more complexity in the management of the optimal strategy in secondary prevention.