Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

LDL-C Lowering in Patients at Intermediate CV Risk

Clin Cardiol; ePub 2018 Mar 25; Cesena, et al

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 (S40%) and another strategy based on achieving LDL-C target ≤100 mg/dL (Starget-100) were simulated. Researchers found:

  • LDL-C and predicted 10-year ASCVD risk would be slightly lower in S40% compared to Starget-100.
  • The number needed to treat to prevent 1 major CV event in 10 years would be 56 with S40% and 66 with Starget-100.
  • S40% would prevent more events in those with lower baseline LDL-C, whereas Starget-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 S40%.


Cesena FHY, Laurinavicius AG, Valente VA, Conceicão RD, Santos RD, Bittencourt MS. Low-density lipoprotein-cholesterol lowering in individuals at intermediate cardiovascular risk: Percent reduction or target level? [Published online ahead of print March 25, 2018]. Clin Cardiol. doi:10.1002/clc.22868.

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