Copyright © 2014 by Türkiye Klinik leri.Objective: We investigated whether statin treatment, associated with slightly increased risk of incident diabetes, confers elevated coronary heart disease (CHD) risk, and circumstances thereof.Material and Methods: Totally, 2959 participants 270 of whom were medicated with statins, and free of CHD at baseline, were analyzed at 7.9-years' follow-up using Cox regression.Results: Participants using statin at baseline-compared with remaining participants-had significantly higher values of metabolic syndrome (MetS) components, but lower apolipoprotein B, were fewer current smokers, and had similar HDL- and LDL-cholesterol levels. Women additionally had higher plasma fibrinogen and lipoprotein[Lp](a). Adjusted Lp(a) concentrations were significantly associated with statin medication, especially in men. In Kaplan-Meier analyses for 381 incident CHD cases (stratified to gender, age category and changed status of statin usage) demonstrated steadily separating curves in statin users, compared with non-users (Log rank <0.0001). Cox regression hazard ratio for developing incident CHD was 2.42 (95% CI 1.80; 3.25) in individuals using statin, after adjustment for traditional risk factors, in men irrespective of MetS-status.Conclusion: Appropriately instituted statin therapy in population subsets with MetS or enhanced inflammation may increase CHD risk in a primary prevention setting. Excess risk imparting may be attributed to a modifying effect of statins on Lp(a).