Most asymptomatic diabetic patients will not benefit from coronary revascularization.

mm in length (1). This was performed in a large cohort of subjects and includes sites that do not contain significant obstructive disease. Although one segment was studied in each subject, each epicardial coronary artery is reflected in the total cohort (i.e., this is not a study of disease limited to the left main segment). Further, the volumetric approach defines segments by the fixed anatomic presence of arterial side branches and provides a greater opportunity for precise matching and investigation of the factors that influence the natural history of atherosclerosis. Studying atherosclerosis within the left main coronary artery, the investigators found no significant correlation between the level of low density lipoprotein (LDL) cholesterol and atheroma burden (8), in support of our findings. Interestingly, they found a significant correlation between baseline LDL cholesterol and progression of atheroma at the region studied. The degree of correlation was much greater than what has been subsequently been reported for the relationship between the degree of change in LDL cholesterol and atheroma volume in patients treated with a statin (6). Given that atherosclerosis is a complex pathological process that results from the influence of a large number of factors on the arterial wall and that there is a substantial overlap between levels of LDL cholesterol and incidence of cardiovascular disease, it would be surprising to expect anything greater than a mild correlation between these factors at most.