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High LDL-C Level May Not Always Spell Trouble for Your Heart Health

A new landmark study published in the journal Circulation found that high LDL-C is only a significant risk factor in people with existing atherosclerosis - as evidenced by a coronary artery calcification (CAC) score greater than zero.

Even a very high LDL-C level (>193 mg/dL) was not correlated with a greater risk of heart disease if participants had a CAC of zero. On the other hand, those with an LDL-C level >193 mg/dL and a CAC greater than zero had a ~3.5-fold higher risk of heart attack compared with those with an LDL-C level >193 mg/dL and a CAC of zero.

This is a crucial finding that can help stratify cardiovascular risk and guide an individualized treatment rather than following the blanket of populational guidelines.

Mortensen MB, Dzaye O, et., al. Low-Density Lipoprotein Cholesterol Is Predominantly Associated With Atherosclerotic Cardiovascular Disease Events in Patients With Evidence of Coronary Atherosclerosis: The Western Denmark Heart Registry. Circulation. 2023 Apr 4;147(14):1053-1063. doi: 10.1161/CIRCULATIONAHA.122.061010.

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