Are Lower LDL Targets Beneficial in Patients with Stable CHD?

Aggressive LDL lowering appears to provide cardiovascular benefit, but in this study it was also associated with higher noncardiovascular mortality.

In light of data from several recent trials, the National Cholesterol Education Panel (NCEP) recently added an optional LDL goal of <70 mg/dL in patients at "very high risk," such as those with acute coronary syndromes, and those with established cardiovascular disease plus multiple major or poorly controlled risk factors (Journal Watch Sep 7 2004). But does this target make sense for all patients with stable coronary heart disease? In this manufacturer-sponsored trial, investigators randomized 10,001 patients with clinically evident CHD and LDL cholesterol levels of <130 mg/dL to receive either 10 mg or 80 mg of atorvastatin daily.

The 10-mg dose lowered LDL to a mean of 101 mg/dL, while the 80-mg dose resulted in a mean level of 77 mg/dL. …

Reviewing Author

Kirsten E. Fleischmann, MD, MPH