Question special

Thanks again to the authors and experts for making this forum happen. I'm thrilled to be able to take part! It’s always exciting when a study demonstrates an effect on primary endpoints, which is why IMPROVE-IT is so huge.
The question that lingers for me, however, is why are all-cause and cardiovascular mortality so difficult to modify using intensive vs. standard dose statins, and now other equivalent lipid lowering therapy, despite clear reductions in cardiovascular events? Is it something about the type of CV events that are prevented, i.e they’re more minor ones? Or is it an issue of power and the size of the potential study it would take to demonstrate out some of these effects?