Cardiovascular (CV) benefit from low-density lipoprotein cholesterol (LDL-C) in patients at intermediate CV risk may be optimized by tailoring the treatment according to baseline LDL-C or by setting a dual-target strategy, a recent study suggests. The study included 1,756 individuals aged 40 to 75 years (94% men) with 10-year risk of atherosclerotic cardiovascular disease (ASCVD) between 5.0% and <7.5% who underwent a routine health screening. For each participant, a strategy based on a 40% LDL-C reduction (S_40%) and another strategy based on achieving LDL-C target ≤100 mg/dL (S_target-100) were simulated. Researchers found:

• LDL-C and predicted 10-year ASCVD risk would be slightly lower in S_40% compared to S_target-100.
• The number needed to treat to prevent 1 major CV event in 10 years would be 56 with S_40% and 66 with S_target-100.
• S_40% would prevent more events in those with lower baseline LDL-C, whereas S_target-100 would be more protective in those with higher LDL-C.
• A dual-target strategy (40% minimum LDL-C reduction and achievement of LDL-C ≤100 mg/dL) would be associated with outcomes similar to those expected with the S_40%.