Clinicians worldwide continue to be challenged by cholesterol management for their patients; specifically, whether to attempt low-density lipoprotein (LDL-C) reduction to previously described targets, or to specific percent reductions (e.g., ≥ 50% or < 50%) based on an individual's risk assessment as advocated by the US Guidelines. Indeed, Canadian and European Guidelines suggest using both strategies. Data addressing whether the high-intensity statin strategy (to achieve ≥ 50% LDL-C reduction) correlates with improved cardiovascular outcomes is limited.
In addition, it is known that LDL-C reduction to the same strength of statin can vary widely in the population4 resulting in a significant number of patients who may continue to be at increased, potentially modifiable risk, for future events. Recently, the Treating to New Targets (TNT) investigators reported in their known coronary artery disease patient population that visit-to-visit variability in LDL-C levels correlated with increased cardiovascular risk, suggesting yet another possible contributor to residual risk, reportedly independent of LDL-C levels.
Source: acc
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