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Baseline low-density lipoprotein cholesterol to predict the extent of cardiovascular benefit from lipid-lowering therapies: a review

2018; Oxford University Press; Volume: 5; Issue: 1 Linguagem: Inglês

10.1093/ehjcvp/pvy038

2055-6845

Eliano Pio Navarese, Felicita Andreotti, Paolo Raggi, Michalina Kołodziejczak, Antonino Buffon, Kevin P. Bliden, Udaya S. Tantry, Jacek Kubica, Gennaro Sardella, Alexander Lauten, Stefan Agewall, Paul A. Gurbel, Marc A. Brouwer,

Health Systems, Economic Evaluations, Quality of Life

Lipid-lowering therapies have been shown to improve cardiovascular outcome in a wide range of patients. The current guidelines recommend a graded approach to reduction in low-density lipoprotein cholesterol (LDL-C) proportional to the patient's risk, with the goal of achieving either a certain magnitude of reduction or a specific threshold of final LDL-C. Recent findings from a meta-analysis of numerous randomized trials suggest that more attention should be given to the baseline LDL-C of an individual patient. In this review, we discuss how the baseline LDL-C level may provide a means to better understand the results of recent cardiovascular outcome trials and the expected benefits of lipid-lowering therapies. The exact quantification of the clinical benefit associate with an intensified lipid-lowering therapy depends on the baseline LDL-C. Mortality is reduced in a log-linear fashion only when LDL-C > 100 mg/dL.