Aggressive reduction of LDL cholesterol levels is safe – and reduces cardiovascular events, a major European conference has been told.
Researchers revealed the latest findings from a trial of a new lipid-lowering drug at the conference of the European Society of Cardiology in Barcelona, Spain.
Nearly 26,000 patients were included in the analysis by US-based researchers. Patients in the FOURIER study were randomised to receive a monoclonal antibody, evolocumab, as well as background statin therapy.
Early results suggested the monoclonal antibody was effective.
The latest analysis showed that cardiovascular events declined "steadily" with levels of LDL cholesterol, the researchers reported.
About 10% of patients – 2,669 – achieved the lowest LDL levels.
According to the research, patients who achieved LDL levels less than 0.26 mmol/L were 40% less likely to experience cardiovascular events than those achieving a level of 2.6 mmol/L.
The researchers conducted further tests on some 1,154 patients to check for cognitive impairment linked to the treatment or to LDL-lowering. They reported no adverse events.
The findings were also being reported in The Lancet today.
Researcher Dr Robert Giugliano, from Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA, said it suggested that "a lower LDL-C target – far below current guidelines – can safely be considered to further reduce the risk of recurrent cardiovascular events in high risk patients.”
He added: "Our findings demonstrate that there is essentially no floor effect, and that lower levels translated to a greater reduction in risk. Among high-risk patients, achieving a LDL cholesterol level far below the most common treatment target of 1.8 mmol/L can further reduce the risk for an adverse cardiovascular event, with no major safety concerns."
Abstract: Clinical Efficacy and Safety of Achieving Very Low LDL-C Levels With the PCSK9 Inhibitor Evolocumab in the FOURIER Outcomes Trial
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