Significant Risk Reduction Achieved with 50% LDL Cholesterol Reduction
Titled “Optimal LDL Cholesterol Target Setting for Korean Patients with Acute Myocardial Infarction,” the study was led by Professor Won Kim of Kyung Hee University College of Medicine. It examined data from 6,248 patients with acute myocardial infarction between 2011 and 2015. The retrospective study showed that patients who reduced LDL cholesterol by 50% or more had a 24% lower risk of major cardiovascular events within five years (hazard ratio: 0.76) compared to those who did not achieve this reduction.
The study divided LDL cholesterol levels into four ranges: 90 mg/dL or higher, 70–89 mg/dL, 55–69 mg/dL, and below 55 mg/dL. Analysis indicated that patients with LDL levels between 55–89 mg/dL had the lowest overall risk of major cardiovascular events. Within this range, the 55–69 mg/dL group exhibited the lowest risk of cardiovascular events, while the 70–89 mg/dL group had the lowest mortality risk.
Continuous analysis identified 74 mg/dL as the level associated with the lowest mortality risk. The study observed a 'J-shaped curve,' showing that LDL levels below this point were linked to a modest increase in risk, suggesting that overly aggressive cholesterol reduction may not always improve outcomes.
Reassessing LDL Targets: 70 mg/dL as a Practical Benchmark
Current South Korean and international guidelines advise myocardial infarction patients to reduce LDL cholesterol by at least 50% from baseline and achieve an absolute level below 55 mg/dL. However, this study suggests that pushing LDL below 55 mg/dL does not yield clear additional benefits. Clinical experts, reviewing the results, propose that an absolute LDL target of approximately 70 mg/dL may be a more practical and effective goal for most patients. They called for prospective clinical trials with larger patient groups to validate these findings.
Shortfalls in LDL Management Highlight Need for Improved Oversight
The study also uncovered significant deficiencies in LDL cholesterol management in clinical settings. Approximately 60% of patients did not reach the 50% reduction target, largely due to insufficient regular LDL testing. Experts emphasized that effective LDL management hinges on both medical prescriptions and active patient involvement. Experts called for stronger collaboration between healthcare providers and patients to improve treatment adherence and outcomes.
The findings also highlighted the need for varied pharmacological approaches, including access to high-cost medications, and the creation of a comprehensive patient registry tailored to South Korea’s healthcare system to support evidence-based clinical decisions.
Accessing the Report
The complete clinical evaluation report is available on the PACEN official website. These findings represent a significant advance in optimizing LDL cholesterol targets for heart attack patients in South Korea, with potential implications for global treatment guidelines.
Lim Hye Jung, HEALTH IN NEWS TEAM
press@hinews.co.kr
