{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:32:29Z","timestamp":1787319149656,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Whether a strategy to target an LDL (low-density lipoprotein) cholesterol &lt;70 mg\/dL is more effective when LDL is reduced &gt;50% from baseline rather than &lt;50% from baseline has not been investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>The Treat Stroke to Target trial was conducted in France and South Korea in 61 sites between March 2010 and December 2018. Patients with ischemic stroke in the previous 3 months or transient ischemic attack within the previous 15 days and evidence of cerebrovascular or coronary artery atherosclerosis were randomly assigned to a target LDL cholesterol of &lt;70 mg\/dL or 100\u00b110 mg\/dL, using statin and\/or ezetimibe as needed. We used the results of repeated LDL measurements (median, 5 [2\u20136] per patient) during 3.9 years (interquartile range, 2.1\u20136.8) of follow-up. The primary outcome was the composite of ischemic stroke, myocardial infarction, new symptoms requiring urgent coronary or carotid revascularization, and vascular death. Cox regression model including lipid-lowering therapy as a time-varying variable, after adjustment for randomization strategy, age, sex, index event (stroke or transient ischemic attack), and time since the index event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Among 2860 patients enrolled, patients in the lower target group who had &gt;50% LDL cholesterol reduction from baseline during the trial had a higher baseline LDL cholesterol and a lower LDL cholesterol achieved as compared to patients who had &lt;50% LDL cholesterol reduction (155\u00b132 and 62 mg\/dL versus 121\u00b134 and 74 mg\/dL, respectively,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001 for both). In the &lt;70 mg\/dL target group, patients with &gt;50% LDL reduction had a significant reduction in the primary outcome as compared to the higher target group (hazard ratio, 0.61 [95% CI, 0.43\u20130.88];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.007) and patients with &lt;50% LDL reduction from baseline had little reduction (hazard ratio, 0.96 [95% CI, 0.73\u20131.26];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.75).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In this post hoc analysis of the TST trial, targeting an LDL cholesterol of &lt;70 mg\/dL reduced the risk of primary outcome compared with 100\u00b110 mg\/dL provided LDL cholesterol reduction from baseline was superior to 50%, thereby suggesting that the magnitude of LDL cholesterol reduction was as important to consider as the target level to achieve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT01252875. URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrialsregister.eu\">https:\/\/clinicaltrialsregister.eu<\/jats:ext-link>\n                      ; Unique identifier: EUDRACT2009-A01280-57.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.123.042621","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T09:01:42Z","timestamp":1687942902000},"page":"1993-2001","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["More Than 50 Percent Reduction in LDL Cholesterol in Patients With Target LDL &lt;70 mg\/dL After a Stroke"],"prefix":"10.1161","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3842-1236","authenticated-orcid":true,"given":"Pierre","family":"Amarenco","sequence":"first","affiliation":[{"name":"APHP, Department of Neurology and 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