This amusing classification was adapted from a quote from Woody Allen concerning the act of change and how we tend to group ourselves in one of the three above. I noticed how the three groups lend itself to the debate over whether to start Crestor now and I came up with the following three groups:

1. Cautious internists might think at first it's prudent to follow path #1, especially after the "statinophobia" following the Baycol withdrawal. However, CAD is the leading cause of mortality and morbidity. In addition, the cholesterol hypothesis of lower LDL being associated with less CHD events is itched in stone.
2. The early Crestor adopters fit in group #2. They will be rewarded with happier, healthier family and patients.
3. Group #3 are those people who still don't believe the cholesterol hypothesis or who don't understand the low incidence of side effects of all statins (2% transaminitis and 0.3% rhabdomyolysis). There are many people dying of CHD needlessly every day with perfectly fine livers and kidneys scared of adverse events that are rare and easy to control. It is group #3 that is doomed to allow history to repeat itself and allow cholesterol to continue its dastardly deed of causing premature cardiovascular events.

Sincerely:

Joseph Saponaro, MD, DABIM, FACP, CCRI, CCRC, CCRP
Board Certified Internist, JPMC
Principal Investigator, DSI
Diplomat American Board of Internal Medicine
Fellow American College of Physicians
Certified Clinical Research Investigator by the ACRP
Certified Clinical Research Coordinator by the ACRP
Certified Clinical Research Professional by SoCRA
Member: The American College of Preventive Medicine