Lowering low-density lipoprotein cholesterol targets to below 1.0 mmol/L in acute coronary syndrome patients: a potential new standard

Despite significant advancements in the diagnosis and treatment of ischemic heart disease primarily, atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. Low-density lipoprotein cholesterol (LDL-C) plays a causal role in the development and progression of atherosclerosis. Randomized controlled trials have demonstrated that achieving lower LDL-C levels in patients with acute coronary syndrome (ACS) can stabilize or even reverse coronary plaque. This article examines existing evidence to explore whether further reducing LDL-C levels in all ACS patients (not just those with recurrent events) to below 1.0 mmol/L, lower than current guideline recommendations, could effectively reduce the incidence of adverse cardiovascular events.