1. Which of the following statements about statins is false?

1. Statins reduce clinical events in case of acute coronary syndrome
2. The benefit of statins is independent of pre-treatment and post-treatment LDL cholesterol levels
3. Use of statins in aggressive doses reduces coronary plaque volume
4. Some studies show that incidence of non-cardiac mortality with statins is high.

Answer: The PROVEIT TIMI 22 study showed that Atorvastatin 80mg given during acute coronary syndrome had significant reduction in clinical events. The Heart Protection Study (HPS) showed consistent and early benefits with the use of statins. The study also showed that the benefit of statins was independent of cholesterol lowering effect. The TNT trial showed a 25% increase in non-cardiac mortality rates with the use of statins. Therefore all the above points are true. The only false statement is (c). The REVERSAL Trial found that patients treated with intensive lipid lowering therapy, though had low cholesterol levels, never had plaque regression. There was a trend for the plaques to remain stable but they never reduced in volume.