Tel Aviv, Israel—Because of the increased risk for recurrent cardiovascular events, long-term treatment with statins is recommended for patients with stable ischemic heart disease (IHD). Appropriate targets for low-density lipoprotein cholesterol (LDL-C) levels remains unclear, however, because the American Heart Association’s guidelines do not establish target LDL-C levels, while the European Society of Cardiology recommends treatment be titrated to achieve LDL-C levels below 70 mg/dL. Research led by the Clalit Research Institute in Tel Aviv, Israel, compared the risk for major adverse cardiac events (MACEs) among 31,619 patients with IHD according to LDL-C levels after at least 1 year of statin therapy, with at least 80% adherence to therapy. In a report published online by JAMA Internal Medicine, results indicate that a low LDL-C level—defined as less than or equal to 70 mg/dL—was not significantly associated with the risk of MACE compared with patients who had moderate LDL-C levels, defined as 70.1 to 100 mg/dL. On the other hand, moderate LDL-C levels were associated with a lower risk of MACE for patients compared with patients who had high LDL-C levels, defined as 100.1 to 130 mg/dL.

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