What is the best strategy for monitoring the lipid-lowering effects of medical therapy used for the primary prevention of coronary artery disease (CAD)?
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There is good evidence that treatment for primary prevention of CAD decreases risk of major first coronary events and cardiovascular mortality, though all-cause mortality has not been shown to be reduced. There is no evidence identifying the best measures for monitoring response to therapy. In the one study that titrated lovastatin, the investigators used a target fasting low-density cholesterol (LDL-C) of 110 mg/dL2. All other studies used a fixed dosage without titration. (Grade of recommendation: C.)