Association of Coronary Plaque With Low-Density Lipoprotein Cholesterol Levels and Rates of Cardiovascular Disease Events Among Symptomatic Adults
Overview
Paper Summary
In a large cohort of symptomatic patients undergoing coronary CT angiography, those with high LDL-cholesterol (≥190 mg/dL) and no coronary plaque or calcium buildup had a low risk of cardiovascular events. This suggests that the presence of plaque, especially calcified plaque, is a better indicator of risk than high LDL-C alone in this population, and could be used to better target intensive treatment.
Explain Like I'm Five
People with high cholesterol but no signs of heart disease on a special heart scan had fewer heart problems. This means the scan might be useful to figure out who really needs stronger cholesterol medicine.
Possible Conflicts of Interest
Dr. Blaha reported receiving grants and personal fees from various pharmaceutical companies. Dr. Pareek reported serving on advisory boards and receiving speaker's fees from pharmaceutical companies. Dr. Nasir reported serving on advisory boards and receiving research support from pharmaceutical companies.
Identified Limitations
Rating Explanation
This is a well-conducted study with a large sample size and robust findings. The results have important clinical implications for risk stratifying patients with high LDL-C. However, limitations such as the short follow-up period and focus on symptomatic patients warrant a slightly lower rating than 5.
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