Is lowering LDL worth while?

The previous results agree with the results of an earlier trial - ENHANCE (Effect of Ezetimibe Plus Simvastatin vs Simvastatin Alone on Atherosclerosis in the Carotid Artery, reference 2). As in the previous trial, simvstatin + ezetimibe reduced the LDL 16% lower that simvastatin alone. Surprisingly, the combined therapy (with the lower LDL) resulted in a larger increase in the CITM (the measure of atherosclerosis), although with limited statistical siginificance. Clearly, however, the ezetimibe and the lowering of LDL were of no use in reducing atherosclerosis.

The same results were obtained in another study (ACCORD, reference 3) for patients with diabetes. Adding fenofibrate (another cholesterol reducing drug) to simvastatin did not improve the risk for heart disease in the patient population.