Lowering Bad Cholesterol to 70 mg/dL Reduces Risk of Ischaemic Stroke

February 25, 2020
By Alex Morrisson LOS ANGELES -- February 24, 2020 -- In patients with a history of stroke or transient ischaemic attacks, reducing low density lipoprotein (LDL) cholesterol to a goal of 70 mg/dL significantly reduces the risk of subsequent cardiovascular events, according to a study presented here at the 2020 International Stroke Conference (ISC). For the study, Pierre Amarenco, MD, Bichat Hospital, Paris, France, and colleagues recruited 1,073 patients to receive statins and other cholesterol-lowering drugs in order to reach an LDL level of 70 mg/dL and another 1,075 patients to reach a level of 100 mg/dL. After a median follow-up of 5.3 years, 12.9% patients who had reduced their LDL to 100 mg/dL experienced an ischaemic stroke, myocardial infarction, urgent coronary revascularisation following unstable angina, urgent carotid artery revascularisation following a transient ischaemic attack, or vascular death compared with 9.6% of patients who had lowered their LDL to a goal of 70 mg/dL (hazard ratio [HR] = 0.74; 95% confidence interval [CI], 0.75-0.94; P = .019). Overall, intracranial haemorrhages occurred in 13 and 11 patients, respectively (HR = 1.17; 95% CI, 0.53-2.62; P = .70). The results showed that the differences in outcome had deepened since an earlier report that analysed outcomes after a median of 3.5 years. At that point, 10.9% of patients in the 100 mg/dL goal group had experienced the composite endpoint compared with 8.5% of those in the 70 mg/dL goal group, the researchers reported. According to Dr. Amarenco, it would require treating 30 patients to the 70 mg/dL goal in order to prevent experiencing the primary endpoint over the timeframe of the study. “Targeting an LDL cholesterol of [Presentation title: Benefit of Targeting a LDL Cholesterol Less Than 70 mg/dL After an Ischemic Stroke of Atherosclerotic Origin: The 5-Year Results of the French Part of the TST Trial. Abstract LB9]