For patients undergoing urgent or emergency CABG who are not taking a statin, it is reasonable to initiate high-dose statin therapy immediately.564 (Level of Evidence: C) Class III: HARM 1. Discontinuation of statin or other dyslipidemic ther- apy is not recommended before or after CABG in patients without adverse reactions to therapy.565 567 (Level of Evidence: B) See Online Data Supplement 24 for additional data on management of hyperlipidemia. In patients with CAD, treatment of hyperlipidemia with therapeutic lifestyle changes and medications reduces the risk of nonfatal MI and death. The goal of such therapy is to reduce the LDL cholesterol level to 100 mg/dL.563 Statins are the most commonly prescribed agents for achieving this goal.563 Studies of lipid-lowering therapy in CABG patients have demonstrated that lowering LDL cholesterol with statins influences post-CABG outcomes, and aggressive LDL cholesterol lowering (to 60 to 85 mg/dL) is associated with a reduced rate of graft atherosclerosis and repeat revasculariza- tion compared with only moderate lowering (130 to 140 mg/dL).545,556 In the latter study, both groups of subjects initially received lovastatin at different doses (40 mg in the aggressive lowering group versus 2.5 mg in the moderate group), and cholestyramine was added if LDL cholesterol goals were not met with lovastatin alone. Of note, patients were maintained on therapy for 1 year, and as many as 11 years, after CABG. 