The American Journal of Medicine website has posted a new continuing medical education module on lowering cholesterol.
LDL Cholesterol Lowering: How and How Low?
Program Overview
The latest American College of Cardiology/American Heart Association lipid management guidelines make two general statements: 1) that elevated LDL cholesterol levels should be treated with the drug class proven in randomized clinical trials (RCTs) to be effective against atherosclerotic cardiovascular disease (ASCVD) events (ie, with statins); and 2) that specific serum LDL cholesterol levels have not been tested and associated with clinical benefit in RCTs and, therefore, these “LDL targets” cannot be recommended. Key RCT results on the therapeutic options (ie, inhibition of HMG-CoA reductase [with statins], of NPC1L1 [with ezetimibe], and of PCSK9 [with PCSK9 inhibitors]) can help inform appropriate clinical management. The esteemed faculty in this educational multimedia program discuss the results of the IMPROVE-IT trial of LDL-lowering therapy and address three questions:
1) Is the benefit of lipid-lowering therapy exclusive to statins, or do the lower LDL levels, per se, provide the benefit?
2) Can serum LDL target levels be the basis for clinical practice guidelines?
3) Can/should clinicians approach the management of LDL cholesterol levels for ASCVD benefit with additional choices in pharmacotherapy