Non-HDL Cholesterol Seems a Better Target Than LDL to Gauge Statin Therapy

LDL cholesterol levels may not be the best target for statin therapy, according to a JAMA meta-analysis.

Researchers examined patient data from eight randomized trials in which nearly 40,000 patients received statins. They assessed whether non-HDL cholesterol or apolipoprotein B were more predictive of future cardiovascular events than LDL.

Increases of one standard deviation from baseline levels of LDL, apoB, and non-HDL at 1 year were all associated with increased risks for cardiovascular events, but the differences between LDL (and apoB) versus non-HDL were significant. Patients reaching the non-HDL target of 130 mg/dL or less, but not the LDL target of 100 mg/dL or less, were at lower risk than those reaching the LDL target but not the non-HDL target.

The authors conclude: "Non-HDL-C may be a more appropriate target for statin therapy than LDL-C."