The lower, the better? Lowering LDL–cholesterol to Prevent Stroke Recurrence

Abstract

In the trials of more versus less statin, the RR per 1.0mmol/L further reduction in LDL cholesterol did not depend on the baseline LDL cholesterol concentration, with significant reductions of 23% in participants who had LDL cholesterol of 2.0–2.5mmol/L reduced further and of 29% in those who had LDL cholesterol lower than 2.0mmol/L (mean 1.71mmol/L) reduced further. “The lower, the better” relation was further confirmed with ezetimibe and PCSK9 inhibitors down to the range of 30mg/dL as the level of LDL–C after treatment. Based on the recent TST trial, target LDL–C level for the prevention of recurrent cardiovascular event may be set below 70mg/dL though Aisan, low body–weight patient, age older than 75 years old may not benefit from the strict control.