High-Dose Atorvastatin vs Usual-Dose Simvastatin for Secondary Prevention After Myocardial Infarction<SUBTITLE>The IDEAL Study: A Randomized Controlled Trial</SUBTITLE>

OWERING OF LOW-DENSITY LIPOprotein cholesterol (LDL-C) with statins has in the last decade become part of the standard treatment regimen in patients with established coronary heart disease (CHD).Following the publication of the results of the Scandinavian Simvastatin Survival Study (4S) in 1994, 1 the most common treatment regimen for such patients in northern Europe has been simvastatin, 20 to 40 mg/d.In a recent trial among patients with acute coronary syndromes, incremental benefit was demonstrated with more intensive lowering of LDL-C to well below 100 mg/dL. 2 In the Treating to New Targets (TNT) study comparing high and low doses of atorvastatin in stable nonacute CHD, a significant improve-For editorial comment see p 2492.