The main principles for LDL-Lowering therapy: There is a causal relationship between low-density lipoprotein cholesterol (LDL-C) and the development of atherosclerotic cardiovascular disease (ASCVD). Trials of LDL Lowering indicate relative risk reduction is proportional to the absolute reduction in LDL-C. Lower LDL-C is better.
Using statin, ezetimibe, or Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors is safe and effective down to < 1 mmol/L (40mg/dl). According to new 2019 ESC/EAS Guidelines, intensity of LDL lowering should be based on risk, irrespective of the cause(s) (e.g., primary or secondary prevention, diabetes, or CKD). Figure 1: The 2019 ESC/EAS Guidelines New Lipid Goals: Greater Benefit from Ezetimibe added to statin in High-Risk patients: TIMI Risk Score for secondary prevention (TRS 20 P) applied to IMPROVE-IT to identify high-risk patients and data…
