Fig 1.
Achieved low density lipoprotein cholesterol (LDL-C) level and risk of cardiovascular disease (CVD) or atherosclerotic CVD (ASCVD) events by (A) subgroups from placebo-controlled statin trials of approximately a mean 5 years duration in the presence of coronary heart disease (CHD), metabolic syndrome (MS), impaired glucose tolerance (IGT) or diabetes (Adapted from Robinson JG, Stone NJ. Am J Cardiol 2006; 98:1405–1408); and subgroups categorized according to extrapolated 10-year ASCVD event rates from (B) moderate versus high intensity statin trials of a mean 3–5 years duration extrapolated to 5 years, and (C) PCSK9 inhibiting monoclonal antibody trials with a mean 2.2–2.8 years duration extrapolated to 5 years; Line represents log linear regression line for relationship between on-treatment LDL-C level and cardiovascular event rate weighted by group size.
Table 1.
Main trial and subgroup characteristics.
Fig 2.
Priorities for adding cardiovascular risk reduction therapies guided by LDL-C above or below 100 mg/dl on maximal statin and lifestyle therapy in patients with ASCVD.
When LDL-C levels are above 100 mg/dl, log linear association evidence for higher ASCVD risk groups and ASCVD risk reductions are substantial. When LDL-C is less than 100 mg, those patient groups with an extensive burden of atherosclerosis and multiple comorbidities, including familial hypercholesterolemia, are likely to have the greatest risk reduction from LDL-C lowering therapy.