Lower LDL Target for Stable CHD Patients?

The cardiovascular benefits of aggressive LDL lowering might come with marginally increased risk for adverse noncardiovascular events.

The National Cholesterol Education Program has introduced an optional LDL-cholesterol goal of <70 mg/dL for patients at very high risk for coronary heart disease, even when baseline levels are <100 mg/dL (Journal Watch Cardiology Sep 3 2004). Adding to the ongoing debate, researchers have conducted a manufacturer-sponsored, double-blind, international trial in which 10,001 patients (mean age, 61; 81% men; 94% white) with clinically evident stable CHD were randomized to receive daily atorvastatin at either 10 mg (LDL goal, 100 mg/dL) or 80 mg (LDL goal, 75 mg/dL). Patients were randomized only if 8-week run-in treatment with open-label 10-mg atorvastatin achieved an LDL level <130 mg/dL.

A significant difference in LDL level emerged between h…

Reviewing Author

Harlan M. Krumholz, MD, SM