JAMA cardiology

Benefits and Risks of Lowering LDL Cholesterol Even More in Patients Who Already Have Very Low Levels: A Combined Study

Abstract

In the Cholesterol Treatment Trialists Collaboration (CTTC), in patients starting with low-density lipoprotein cholesterol (LDL-C) levels of approximately 3.4 mmol/L (131.5 mg/dL), there was a 22% reduction in major vascular events per 1-mmol/L (38.7-mg/dL) lowering of LDL-C. The magnitude of clinical benefit of further LDL-C lowering in patients already with very low LDL-C levels remains debated.

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Competing interests

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. The TIMI Study Group has received grant support from Abbott Laboratories; Amgen; AstraZeneca; Critical Diagnostics; Daiichi-Sankyo; Eisai; Genzyme; Gilead; GlaxoSmithKline; Intarcia; Janssen Research and Development; Medicines Company; MedImmune; Merck; Novartis; Poxel; Pfizer; Roche Diagnostics; and Takeda. Dr Sabatine reports receiving honoraria for consulting from Alnylam; Amgen; AstraZeneca; Bristol-Myers Squibb; CVS Caremark; Dyrnamix; Esperion; Intarcia; Ionis; Janssen Research and Development; Medicines Company; MedImmune; Merck; MyoKardia; and Novartis. Dr Wiviott reports receiving consultant/advisory board fees from Angelmed, Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Aegerion, Janssen, Merck, Arena, Xoma, Amgen, and ICON Clinical and Boston Clinical Research Institute. Dr Wiviott’s spouse is employed by Merck. Ms Murphy reports receiving consultant/advisory board fees from Amgen. Dr Giugliano reports receiving honoraria for continuing medical education activities from Amgen, Daiichi Sankyo, and Merck; and consulting/advisory board fees from Amarin, Amgen, Daiichi-Sankyo, Lexicon, Bristol Myers Squibb, CVS Caremark, GlaxoSmithKline, and Pfizer. No other disclosures were reported.
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