Abstract

LOW DENSITY LIPROPROTEIN CHOLESTEROL GOAL LEVELS IN CARDIOVASCULAR SECONDARY PREVENTION

Martín A. Urtasun, Gustavo H. Marin*, Cristian Dorati1, Eliseo Ferrari, Héctor O. Buschiazzo, Perla Mordujovich de Buschiazzo

ABSTRACT

The Scandinavian Simvastatin Survival Study showed that the reduction of low density lipoprotein (LDL) cholesterol levels diminished 30% all causes mortality in coronary heart disease (CHD) patients. Later trials with statins indicated a positive relationship between CHD secondary prevention and continuously lower LDL-C levels. The Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High blood Cholesterol in Adults (Adult Treatment Panel III [ATP III]), recommended drug treatment of CHD or CHD risk equivalents patients, with LDL-C above 130 mg/dl and optional treatment between 100 and 129 mg/dl, with a goal value  100 mg/dl. In 2004, the same Program recommended an LDL-C goal of  70 mg/dl when cardiovascular risk is very high. This review examines main published clinical trials (2001-2016) of statins efficacy on CV secondary prevention, specially with LDL-C levels lower than 100 mg/dl and discusses its implementation at the current medical practice.

Keywords: Lipoproteins, LDL cholesterol, Coronary disease, drug therapy, Anticholesteremic Agents, Hydroxymethylglutaryl-CoA Reductase Inhibitors.