LDL Controlled — But Is Your Patient Truly Risk-Free?

Your patient’s LDL is 68 mg/dL. Statin optimized. Numbers look perfect. But is the atherosclerotic process truly under control? Consider a patient with metabolic syndrome: obesity, hypertension, insulin resistance, and dyslipidemia.

He is on statin therapy with an LDL-C of 70 mg/dL: technically “at goal”. Yet his triglycerides remain elevated at 200 mg/dL and HDL-C is low at 30 mg/dL. We could intensify LDL lowering further by maximizing statins, adding ezetimibe, or even considering PCSK9 inhibition, but these strategies do little to address persistent hypertriglyceridemia and do not eliminate residual cardiovascular risk. Residual Risk: When LDL Is Not the Whole Story Low-density lipoprotein (LDL) remains central to atherosclerotic cardiovascular disease (ASCVD). LDL particles are the fundamental building blocks of arterial plaque and serve as a validated surrogate marker of…