Threshold level or not for low-density lipoprotein cholesterol

As drugs, such as the statins, and other therapies demonstrate the ability to significantly lower levels of low-density lipoprotein cholesterol (LDL-C ), one issue is whether there is a lower threshold below which no further d ecline in coronary heart disease occurs. Those who evaluate the data from m ultiple trials and conclude that no significant decrease in coronary event rates occurs at or below 125 mg/dL suggest using this level as a guideline for clinical-application of cholesterol-lowering therapy. On the other hand , analysis of the results of the same population and primary prevention stu dies concludes that no such threshold exists. The issues affected by the de cision of whether to use a threshold include costs to the healthcare system for additional physician time, tests, and medication; unknown clinical eve nts and safety related to very low LDL-C; and resource prioritization to an unestablished therapeutic approach.