A case -based approach was used to confer on this very relevant subject. Three case scenarios were discusssed. Treat to target has the most widely used strategy in the past 15 years, but there are 3 problems with this approach. The current clinical trial data do not indicate what the target should be.
We do not know the magnitude of additional ASCVD risk reduction that would be achieved with on target lower than another. It does not take into account potential adverse effects from multidrug therapy that might be needed to achieve a specific goal. Rather than LDL-C or non HDl-C targets, the 2013 ACC/AHA guideline used the intensity of statin therapy as the goal of tratment. Four groups of individuals were identified for whom an extensive body of RCT evidence demonstrared a reduction in ASCVD events with a good margin of safety from moderate-or high intensity statin therapy.…
