Projected Impact of LDL-C and HbA1c Control on Cardiovascular Outcomes in ASCVD and Diabetes

doi:10.1016/j.jacadv.2026.103308

Projected Impact of Low-density Lipoprotein Cholesterol (LDL-C) and Hemoglobin A1c (HbA1c) Control on Cardiovascular Outcomes in Atherosclerotic Cardiovascular Disease (ASCVD) and Diabetes

JACC AdvPublished 7 Oct 2026Using National Health and Nutrition Examination Survey 2011 to 2020 data weighted to the U.S. population

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Authors' conclusion

In U.S. adults with ASCVD and DM, LDL-C control provides the greatest projected reduction in ASCVD risk among individual risk factors, whereas comprehensive control of LDL-C, glycemia, and weight produces the greatest overall projected benefit.

Study context

Population: Adults with ASCVD and diabetes mellitus (DM) with uncontrolled LDL-C (≥70 mg/dL) and HbA1c (≥7.0%)representing 1.73 million U.S. adults
Participants: 131 adults

Exposure: scenarios achieving guideline-recommended targets vs patients' baseline LDL-C, HbA1c, and body mass index (BMI) values

Methodological detailsTIMI risk score

TIMI risk score

Main finding

As reported in the abstract

Predicted relative risk reductions and predicted preventable events · 3 years

LDL-C lowering to 70 mg/dL18.0%38,200 events

LDL-C lowering to 55 mg/dL23.7%50,100 events

additional control of HbA1c29.3%62,100 events

additional BMI reductions37.0%66,500 events

Observational data: associations, not effects.

Original publication

Projected Impact of LDL-C and HbA1c Control on Cardiovascular Outcomes in ASCVD and Diabetes. JACC Adv. Published 7 October 2026. doi:10.1016/j.jacadv.2026.103308

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it