Statins inhibit the HMG-CoA reductase enzyme, the rate-limiting step in cholesterol biosynthesis, and are powerful drugs for lowering LDL-C, with reductions 50% observed with the high-intensity statin regimens. Statins have been shown in multiple secondary prevention trials to reduce cardiovascular events, including coronary heart disease death, recurrent MI, cerebrovascular events, coronary revascularization, and all-cause mortality.50 52 They have also been shown to delay coronary atherosclerosis progression and possibly induce plaque regression, on serial angiographic and intravascular ultrasonographic studies. Given that the clinical evidence does not support the notion of titrating statin therapy to achieve a proposed LDL-C target and that statins are beneficial in all patients at high cardiovascular risk irrespective of their LDL-C levels, the paradigm of treating patients to LDL-C targets is largely abandoned.14,18 On the other hand, high-intensity statin therapy appears to confer incremental clinical benefit compared with less intensive therapy.53 The Cholesterol Treatment Trialists conducted meta-analyses of individual participant data from randomized trials of more versus less intensive statin regimens (5 trials; 39612 patients).53 They demonstrated that more intensive regimens produced a highly significant 15% further reduction in major vascular events, driven by reductions in coronary death or non-fatal MI, coronary revascularization, and ischemic stroke.53 The 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults recommends treatment of patients 75 y of age who have clinical atherosclerotic cardiovascular disease (including those with MI) with high-intensity statin.14 Moderate-intensity statins are recommended in their counterparts >75 y of age and in those who have contraindications/intolerance to high-intensity regimens. 