Prevention & lipidsRandomised controlled trial
A Comparison of Two Low-density Lipoprotein (LDL) Cholesterol Targets after Ischemic Stroke
- Randomised controlled trial
- parallel-group
- France and South Korea
- Stopped for administrative reasons after 277 of an anticipated 385 end-point events
Authors' conclusion
After an ischemic stroke or TIA with evidence of atherosclerosis, patients who had a target LDL cholesterol level of less than 70 mg per deciliter had a lower risk of subsequent cardiovascular events than those who had a target range of 90 mg to 110 mg per deciliter.
Study context
- Population
- Ischemic stroke in previous 3 months or transient ischemic attack (TIA) within previous 15 days, with cerebrovascular or coronary-artery atherosclerosis; all on a statin, ezetimibe, or both
- Participants
- 2,860 participants
- Comparison
- LDL cholesterol target <70 mg/dL vs 90–110 mg/dL
- Lower targetn = 1,430
- Higher targetn = 1,430reference
- Primary endpoint
- Major CV events:
- Ischemic stroke
- MI
- New symptoms leading to urgent coronary or carotid revascularization
- CV death
- Follow-up
- Median 3.5 years
Primary result
As reported in the abstract
Adjusted hazard ratio
0.78
95% CI 0.61–0.98
P = 0.04
Events by treatment group
Lower target vs Higher target
adjusted HR 0.78 (95% CI 0.61–0.98); P = 0.04
Further findings
Achieved LDL cholesterol level
- Achieved LDL cholesterol level: mean baseline LDL cholesterol 135 mg per deciliter
Safety
Intracranial hemorrhage and newly diagnosed DM
- Did not differ significantly between the two groups
Original publication
A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. N Engl J Med. Published 18 November 2019. doi:10.1056/nejmoa1910355
Summarised from the published abstract; every number is checked against it