Low-Density Lipoprotein Cholesterol (LDL-C): How Low?

Author(s): Thomas F. Whayne*.

Journal Name: Current Vascular Pharmacology

Volume 15 , Issue 4 , 2017

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Abstract:

Low-density lipoprotein cholesterol (LDL-C) is a well-established major cardiovascular (CV) risk factor supported by clinical evidence showing decreased atherosclerotic disease events when LDL-C is therapeutically lowered. A reasonable approach is to tailor each patient’s LDL-C target level depending on the initial LDL-C level and the perceived risk. Multiple clinical entities such as the newborn, hypobetalipoproteinemia, proprotein convertase subtilisin/kexin type 9 (PCSK9) missense mutations, and an unexpected excess response to a statin or other medications, are associated with very low LDL-C levels in otherwise healthy individuals. Therefore, an issue of major interest to clinicians who buy into “lower is better” for LDL-C in the high-risk CV patient is how low can and should the LDL-C be taken? Available information is discussed and placed into context. A definite safe lowest LDL-C level cannot be specified but there appears to be support that a level as low as 20 mg/dL (0.52 mmol/l) can be justified in the highest CV risk patients with extensive atherosclerosis where plaque stabilization and regression are necessary.

Keywords: Coronary artery disease, low-density lipoprotein cholesterol, peripheral arterial disease, proprotein convertase subtilisin/ kexin type 9, statins.

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Article Details

VOLUME: 15
ISSUE: 4
Year: 2017
Page: [374 - 379]
Pages: 6
DOI: 10.2174/1570161115666170227102708
Price: $58

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