More contemporary studies have convincingly established the efficacy of statins in the primary and second- ary prevention of coronary events.394 396,398,400,501,519 522 In a prospective meta-analysis published by the Cholesterol Treat- ment Trialist Collaborators in 2010 that examined data from 26 randomized trials of statin therapy (comparing higher- to lower-dose statin therapy or statin therapy to a control regimen), the mean difference in LDL cholesterol was 31 mg/dL, ranging from 12 to 68 mg/dL. Each 40-mg/dL reduction in LDL cholesterol was associated with a 10% reduction in all-cause mortality and a 20% reduction in coronary mortality, with corresponding reductions in nonfatal MI, need for coronary revascularization, and first nonfatal ischemic stroke.458 The absolute benefit of therapy was a *The use of bile acid sequestrant is relatively contraindicated when triglycerides are $200 mg/dL and is contraindicated when triglycerides are $500 mg/dL. Dietary supplement niacin must not be used as a substitute for prescription niacin. Fihn et al Stable Ischemic Heart Disease: Full Text e395 function of an individual s absolute risk of fatal MI.458 In trials comparing higher- to lower-dose statin therapy, the average, weighted reduction in LDL cholesterol at 1 year was 20 mg/dL among those receiving higher-dose regimens. Among patients assigned to more intensive regimens, there was a 15% lower incidence of major vascular events (95% CI: 11 to 18; P,0.0001), which reflected a 13% lower risk of coronary death or nonfatal MI (95% CI: 7 to 19; P,0.0001), a 19% lower risk of undergoing coronary revascularization ischemic stroke (95% CI: 5 to 26; P50.005). The reductions in serum LDL cholesterol and in cardiovascular risk were similar in magnitude to those observed in trials comparing statin therapy to a control regimen. 