Why do we need another metric in dyslipidemia management? Low-density-lipoprotein cholesterol (LDL-C) is currently the primary treatment target for dyslipidemia management.However, it has been shown that the risk for future coronary artery disease (CAD) events remains high in patients who have attained the guideline-recommended LDL-C goals. For example, in the Pravastatin or Atorvastatin Evaluation and Infection Therapy (Prove-It TIMI22) trial,22.7% of the patients had a recurrent event at 2 years of follow-up despite attaining LDL-C levels of 67 mg/dL and receiving optimal medical care. It is important to note that this event rate is probably an underestimation of the recurrent event rate in everyday clinical practice, where patient characteristics and the dynamics of care are different from those in a randomized clinical trial setting.
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