A Comparison of Two LDL Cholesterol Targets After Ischemic Stroke

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The purpose of this study was to evaluate target levels for LDL cholesterol to reduce cardiovascular events after stroke or TIA. A total of 2860 patients in France and South Korea were randomly assigned to a target LDL cholesterol level of <70 mg/dL or 90 to 110 mg/dL. All patients had either ischemic stroke within the prior 3 months or TIA within the prior 15 days. All were treated with statin, ezetimibe, or both and had evidence of cerebrovascular disease or CAD. Patients were followed for a median of 3.5 years. Mean achieved LDL cholesterol was 65 mg/dL in the lower-target group and 96 mg/dL in the higher-target group. The primary endpoint of major cardiovascular events occurred in 8.5% of patients in the lower-target group and in 10.9% in the higher-target group (aHR, 0.78; P=.04).

Following ischemic stroke or TIA in patients with evidence of cerebrovascular disease or CAD, treatment to a target LDL cholesterol level of <70 mg/dL was associated with a lower risk of subsequent CV events than treatment to a target level of 90 to 110 mg/dL.