Limit to Benefits of Large Reductions in Low-Density Lipoprotein Cholesterol Levels: Use of Fractional Polynomials to Assess the Effect of Low-Density Lipoprotein Cholesterol Level Reduction in Metaregression of Large Statin Randomized Trials

摘要

A recent metaregression of 25 large statin randomized trials involving 155 613 participants and 23 791 major vascular events reported a significant reduction in the risk of major vascular events associated with a reduction in low-density lipoprotein cholesterol (LDL-C) level. The question that naturally follows is whether there is a threshold for the benefit of LDL level reduction that can be achieved with statins or whether greater reductions in LDL level would bring greater reductions in vascular events.