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De acuerdo con la medicina basada en la evidencia, la reducción del colesterol de las lipoproteínas de baja densidad (LDL) comporta el mayor beneficio cardiovascular, lo que justifica el empleo de las estatinas a las dosis óptimas como eje principal de la prevención. Según el metaanálisis del Cholesterol Treatment Trialists’ (CTT) Collaboration, con 170.000 participantes en 26 ensayos de intervención con estatinas, por cada reducción de 1,0 mmol/l (38 mg/dl) en colesterol LDL se consigue una disminución del 21% del riesgo relativo de presentar un episodio cardiovascular. Sin embargo, aún en el mejor de los supuestos, después de alcanzar el objetivo en colesterol LDL gracias al uso de estatinas, aún persiste un elevado riesgo residual atribuido a distintos factores, tanto lipídicos como no lipídicos.
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