After 10 years of studies on statins in acute coronary syndromes what have we learned? (1) The use of statins in acute coronary syndromes reduces coronary events during follow-up; (2) an "intensive" strategy based on the use of potent high dosage statins is effective on 4 to 6 months prognosis, nevertheless side effects and drug withdrawal are frequent; (3) beyond the usual paradigm "the lower the better", the new paradigm of "long term sustainability" should be developed, adopting adequate strategies; (4) a target-oriented study on statins in acute coronary syndrome is desirable, to evaluate which LDL values should be achieved or maintained for the best prognostic benefit.