Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
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Optimal Target Low-density Lipoprotein Level for Reducing the Risk of Atherosclerotic Cardiovascular Diseases: A Systematic Review and Meta-analysis

  • Min-Gyo Jang (College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University) ;
  • Yeung-Eun Son (College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University) ;
  • Hye Duck Choi (College of Pharmacy, Yeungnam University) ;
  • Junwoo Kim (Department of Family Medicine, Daegu Health College Hospital) ;
  • Tae-Eun Kim (College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University) ;
  • Kwang-Hee Shin (College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University)
  • Received : 2023.09.11
  • Accepted : 2023.12.15
  • Published : 2023.12.31
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Abstract

Background: As per guidelines for treating dyslipidemia, the recommended low-density lipoprotein cholesterol (LDL-C) level in extremely high-risk patients, including those with coronary artery diseases is <55 mg/dL. Although this recommendation has been adopted in the guidelines for dyslipidemia in various countries, there is limited evidence of its efficacy in reducing cardiovascular diseases (CVDs), especially among East Asian patients. This study aimed to investigate whether an LDL-C value below 55 mg/dL is associated with decreased risk of CVDs. Methods: Seven clinical trials including 50,970 patients that compared intensive lipid-lowering therapy with less therapy or placebo in patients who had >6 months of follow-up, those with a sample size of ≥150 were selected as the final literature for analysis. Risk ratios (RR) using random effects were represented with 95% confidence intervals (CI) for the reliability of the results. Results: An LDL-C level of <55 mg/dL was related to significantly reduced events of major CVDs (RR: 0.88; 95% CI: 0.80-0.98) and myocardial infarction (RR: 0.81; 95% CI: 0.73-0.90) and a reduced risk of ischemic stroke (RR 0.79; 95% CI 0.69-0.89, mean follow-up=2 years). However, an LDL-C level below 55 mg/dL did not reduce the incidence of CVD in intensive therapy in East Asian patients. Conclusions: A goal LDL-C value below 55 mg/dL was identified to be related to a decreased risk of developing CVD. However, the relation to LDL-C below 55 mg/dL with a decreased risk of CVD was not observed in East Asian patients.

Keywords

Acknowledgement

This study was conducted with the support of the CPRN Research Council of the Korean Society of Clinical Pharmacy (KCCP20210515CPRN), and by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. RS-2023-00251397).

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