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Frank M. Sacks, MD

JAMA. 2001;285:1758-1760.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In the unstable clinical state after an acute coronary disease event, patients experience a high rate of serious complications including death, myocardial infarction (MI), and progressively recurring unstable angina requiring intervention.¹ The incidence rate sharply declines after 1 month, and then gradually diminishes so that after about 6 months, the incidence of coronary death and MI is fairly constant for the next several years, reflecting a stabilization of the clinical coronary disease. Many successful clinical strategies—including antithrombotic therapy, -adrenergic blockade, thrombolysis, and angiotensin-converting enzyme inhibition—have been directed toward reducing the high early event rate after onset of acute coronary syndrome.¹ Nonetheless, the incidence of serious complications remains high.

The previous groundbreaking secondary prevention trials of lipid therapy were designed to be unequivocal tests of the lipid theory.^2-5 Death or definite nonfatal MI were the necessary outcomes. Patients were enrolled only after they survived, event-free, for several . . . [Full Text of this Article]

Author Affiliation: Department of Nutrition, Harvard School of Public Health, and Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

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