What’s the Ideal LDL Target for Patients with Cardiovascular Disease?

Clinical Takeaway

: In this randomized trial, treating to an LDL target of <55 mg/dl prevented more cardiovascular events than treating to <70 mg/dl.

Context

The optimal LDL cholesterol target for secondary prevention has been uncertain, given the lack of head-to-head clinical trials. In this open-label, randomized trial, researchers compared an intensive LDL goal (<55 mg/dl) with a conventional one (<70 mg/dl) among 3000 patients with stable cardiovascular disease (average age, 64; median LDL, 76 mg/dl). Two thirds of the patients had undergone a revascularization procedure.

Key Results

During the 3-year trial, median LDL levels dropped more with the intensive target than the conventional one (to 56 vs. 66 mg/dl). The reductions in both groups were achieved primarily through high-intensity statins and ezetimibe.
The primary end point — a composite of nonfatal myocardial infarction, nonfatal…

Reviewing Author

Christopher W. Goodman, M.D.

Disclosures

Nothing to disclose