A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke
Statins medication is recommended after a transient ischemic attack (TIA) as intensive care to lower serum lipids. Still, target levels for low-density lipoprotein (LDL) cholesterol that can reduce adverse cardiovascular events in the future are unknown. Kim and colleagues conducted a study titled “A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke” published in The New England Journal of Medicine. Summary of the research is provided below:
Objectives:
To provide evidence-based recommendations for the target level of LDL to reduce the risk of cardiovascular events after stroke.
Method:
Patients with ischemic stroke in the last three months or TIA in the last 15 days were selected. These patients were randomly assigned with an LDL cholesterol target level of less than 70 mg per deciliter or a target range of 90-110mg per deciliter. All patients had evidence of prior coronary artery or cerebrovascular atherosclerosis received a statin, ezetimibe, or both.
Findings:
Patients with target level LDL cholesterol of less than 70 mg per deciliter were found with fewer major cardiovascular events than the other group with 90-110 mg per deciliter target. Research encourages target treatment for blood pressure and diabetes along with smoking cessation while monitoring low LDL levels. A higher number of intracranial haemorrhages are reported in the lower target group, this matches with observation in Stroke Prevention by Aggressive Reduction in Cholesterol Level (SPARCL) trial. But unlike the SPARCL trial, this trial doesn’t report significant between-group differences for incident diabetes.
Limitations:
Investigators acknowledge future researches to study the beneficial effect of LDL cholesterol target levels of less than 50 mg per deciliter. Due to a shortage of funds, the study was terminated. This limited findings for secondary endpoints.
Image Credit: Heart photo created by jcomp – www.freepik.com