Treat-to-target or high-intensity statin in clinical CAD? ACC23 WCCardio
A one-size-fits-all, high-intensity statin approach avoids the bother and costs of statin titrated guided by serial LDL-C assays, but doesn't consider"individual variability in drug responses," Hong toldIn contrast, he said, statin treatment to LDL-C target"could allow a tailored approach and facilitate patient–physician communication, which can enhance adherence to therapy," potentially rendering high-intensity statins"less needed.
The latter strategy is consistent with current US guidelines for secondary prevention, which recommend treatment to achieve at least a 50% drop in LDL-C using high-intensity statins plus, as necessary,LODESTAR's target-based approach called for lowering LDL-C levels to the 50-70 mg/dL range, in line with guidelines when the trial was designed in 2015, the report states.
Virani agrees that some patients who are statin"hyper-responders" may achieve their LDL-C targets on no more than a moderate-intensity statin, thereby avoiding escalation to high-intensity statins. In practice, however, most patients would either proceed to high-intensity statins, as tolerated, or add a non-statin LDL-lowering medication to get below 70 mg/dL.
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