{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T13:53:21Z","timestamp":1740146001751,"version":"3.37.3"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T00:00:00Z","timestamp":1521936000000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Recommendations for blood cholesterol management differ across different guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Lipid\u2010lowering strategies based on low\u2010density lipoprotein\u2010cholesterol (LDL\u2010c) percent reduction or target concentration may have different effects on the expected cardiovascular benefit in intermediate\u2010risk individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We selected individuals between 40 and 75\u2009years of age with 10\u2010year risk for atherosclerotic cardiovascular disease (ASCVD) between 5.0% and &lt;7.5% who underwent a routine health screening. For every subject, we simulated a strategy based on a 40% LDL\u2010c reduction (S<jats:sub>40%<\/jats:sub>) and another strategy based on achieving LDL\u2010c target \u2264100\u2009mg\/dL (S<jats:sub>target\u2010100<\/jats:sub>). The cardiovascular benefit was estimated assuming a 22% relative risk reduction in major cardiovascular events for each 39\u2009mg\/dL of LDL\u2010c lowered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study comprised 1756 individuals (94% men, 52\u2009\u00b1\u20095\u2009years old). LDL\u2010c and predicted 10\u2010year ASCVD risk would be slightly lower in S<jats:sub>40%<\/jats:sub> compared to S<jats:sub>target\u2010100<\/jats:sub>. The number needed to treat to prevent 1 major cardiovascular event in 10\u2009years (NNT<jats:sub>10<\/jats:sub>) would be 56 with S<jats:sub>40%<\/jats:sub> and 66 with S<jats:sub>target\u2010100<\/jats:sub>. S<jats:sub>40%<\/jats:sub> would prevent more events in individuals with lower baseline LDL\u2010c, whereas S<jats:sub>target\u2010100<\/jats:sub> would be more protective in those with higher LDL\u2010c. A dual\u2010target strategy (40% minimum LDL\u2010c reduction and achievement of LDL\u2010c\u2009\u2264100\u2009mg\/dL) would be associated with outcomes similar to those expected with the S<jats:sub>40%<\/jats:sub> (NNT<jats:sub>10<\/jats:sub> =\u200955).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In an intermediate\u2010risk population, cardiovascular benefit from LDL\u2010c lowering may be optimized by tailoring the treatment according to the baseline LDL\u2010c or by setting a dual\u2010target strategy (fixed dose statin plus achievement of target LDL\u2010c concentration).<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22868","type":"journal-article","created":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T17:49:25Z","timestamp":1522000165000},"page":"333-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Low\u2010density lipoprotein\u2010cholesterol lowering in individuals at intermediate cardiovascular risk: Percent reduction or target level?"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1051-9434","authenticated-orcid":false,"given":"Fernando H. Y.","family":"Cesena","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Gabriele","family":"Laurinavicius","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviane A.","family":"Valente","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel D.","family":"Concei\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul D.","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"},{"name":"Heart Institute (InCor) University of S\u00e3o Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcio S.","family":"Bittencourt","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein  S\u00e3o Paulo Brazil"},{"name":"University Hospital, University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60367-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31357-5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2015.02.003"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw272"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g4356"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.07.510"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487314543074"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.005"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.10.024"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/2047487316667785"},{"key":"e_1_2_7_15_1","first-page":"518","article-title":"The expected cardiovascular benefit of plasma cholesterol lowering with or without LDL\u2010C targets in healthy individuals at higher cardiovascular risk","volume":"108","author":"Cesena FHY","year":"2017","journal-title":"Arq Bras Cardiol."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600176"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.03.519"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms6068"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw046"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22868","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22868","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T08:07:45Z","timestamp":1694938065000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1002\/clc.22868"],"URL":"https:\/\/doi.org\/10.1002\/clc.22868","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"type":"print","value":"0160-9289"},{"type":"electronic","value":"1932-8737"}],"subject":[],"published":{"date-parts":[[2018,3]]},"assertion":[{"value":"2017-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-12-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}