Of note, patients were maintained on therapy for 1 year, and as many as 11 years, after CABG. The PROVE IT TIMI-22 (Pravastatin or Atorvastatin Evaluation and Infection Therapy: Thrombolysis in Myocar- dial Infarction) trial randomly assigned patients with ACS, a Presence of established cardiovascular disease plus 1) multiple major risk factors (especially diabetes), 2) severe and poorly controlled risk factors (especially continued cigarette smoking), 3) multiple risk factors of the metabolic syndrome (especially high triglycerides 200 mg/dL plus non high-density lipoprotein cholesterol 130 mg/dL with low high-density lipoprotein cholesterol [ 40 mg/dL]), and 4) acute coronary syndromes. minority of whom had previous CABG, to intensive (LDL cholesterol goal 70 mg/dL) versus standard (LDL choles- terol goal 100 mg/dL) lipid-lowering therapy. The benefit of intensive therapy (a reduction in death, MI, recurrent UA, repeat revascularization, or stroke) was observed within 30 days.561 In the occasional subject who cannot take statins, alternative hypolipidemic agents, such as bile acid seques- trants, niacin, and fibrates, should be considered, in accor- dance with National Cholesterol Education Program: Adult Treatment Panel III guidelines.563 4.3.1. Timing of Statin Use and CABG Outcomes As noted, the benefits of post-CABG LDL lowering with statins have been reported previously, but no prospective studies of the impact of preoperative LDL cholesterol lower- ing on post-CABG outcomes are available. 