Counterpoint: Low-Density Lipoprotein Cholesterol Targets Are Not Needed in Lipid Treatment Guidelines

Abstract

On the basis of accumulating evidence, low-density lipoprotein cholesterol (LDL-C) treat-to-goal approaches no longer seem to be the best way to optimize lipid-modifying therapy to prevent atherosclerotic cardiovascular disease (ASCVD). The potential for a net ASCVD risk reduction benefit is a more individualized approach to clinical decision making and may better inform patient preferences. However, risk estimation tools will need to be developed to facilitate more personalized CVD risk estimation in statin-treated patients. In the meantime, LDL-C thresholds rather than targets may aid in determining which patients might benefit from additional LDL-C-lowering therapy beyond statins.