High cholesterol secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Kashish Goel, M.D.

Overview

Patients with coronary heart disease or newly diagnosed acute coronary syndrome are at a high risk of recurrent coronary events. In addition to modification of lifestyle factors, LDL lowering has been shown to reduce recurrent events, cardiovascular deaths and all-cause mortality in these patients. According to the NCEP ATP III guidelines, LDL cholesterol of < 100 mg/dL is the goal in patients with CHD and CHD risk equivalents. The NCEP recommendations are mentioned here, in addition to recent evidence.

Therapy goals

NCEP ATP III guidelines recommended a LDL goal < 100 mg/dL for CHD or CHD risk equivalents, however drug therapy was considered optional between a LDL of 100 to <130 mg/dL. An update by the NCEP committee in 2004 based on new trial data recommended starting drug therapy simultaneously with therapeutic lifestyle changes in CHD patients with LDL < 100 mg/dL. An optional goal of LDL < 70 mg/dL was recommended in high risk patients.