Abundant clinical trial evidence supports the importance of LDL cholesterol-lowering in decreasing coronary artery disease (CAD) risk. Even in trials of statin therapy in which substantial reductions of LDL have been obtained, statin decrease by 24-37%, but do not entirely eliminate events. This is suggesting that other lipid parameters such as HDL, triglyceride, Lp(a), LDL particle size and susceptibility of LDL to oxidation should be considered. Furthermore, fibrinolytic activity, hyperinsulinemia, hyperhomocysteinemia and alcohol consumption should be also included as parameters to obtain significant benefit.