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Targeting LDL Below 55 mg/dL Cuts Cardiac Events by About One-Third

The finding strengthens a move toward tighter cholesterol goals for people already living with heart disease.

Overview

  • The Ez-PAVE randomized trial in 3,048 South Korean patients with atherosclerotic cardiovascular disease found 6.6% vs 9.7% major events over three years when targeting LDL below 55 mg/dL rather than below 70 mg/dL.
  • Researchers reported similar rates of prespecified safety outcomes between groups, with fewer creatinine elevations in the lower-target group.
  • The drop in risk was driven mainly by fewer nonfatal heart attacks and fewer procedures to reopen blocked arteries.
  • The results were published in the New England Journal of Medicine and presented at the American College of Cardiology’s annual meeting in New Orleans.
  • The evidence aligns with recent U.S. guidance that favors lower LDL goals, and it may prompt more use of add-on drugs like ezetimibe, bempedoic acid, or PCSK9 inhibitors to help patients reach targets and avoid repeat events.