The purpose of this study is to examine in detail the acute and chronic effects of pitavastatin on plasma lipid transport and atheroma biomarkers in patients at elevated risk for the premature development of atherosclerosis (CAPITAIN).

Inclusion Criteria:

• Patients with metabolic syndrome
• Patients with LDL-C > 130mg/dL
• Eligible, able to participate and have given informed consent

Exclusion Criteria:

• Body Mass Index >35 kg/m2
• LDL-C > 190mg/dL
• Fasting triglycerides > 400 mg/dL
• Diabetes mellitus (fasting glucose >7 mmol/L) or taking diabetic therapy
• Uncontrolled hypertension (Systolic Blood Pressure >= 140 mmHg or Diastolic Blood Pressure >= 90mmHg)
• Any conditions that cause secondary dyslipidaemia or increase the risk of statin therapy
• ALAT and ASAT >3 x ULRR
• Impaired renal function (Serum Creatinine >1.5 x ULRR or eGFR <60 mL/min)
• History of any muscle disease or unexplained elevation (>3 x ULRR) of serum creatine kinase
• Evidence of symptomatic heart failure (NYHA class III or IV)
• Current or recent user of supplements or medications known to alter lipid metabolism