The lifetime accumulation of cholesterol delivered by LDL within the arterial wall causes atherosclerosis and is a key modifiable factor for the development of ASCVD.1-6
In this section, you will learn more about cholesterol synthesis, regulation via the LDL receptor, and how the accumulation of cholesterol delivered by LDL causes atherosclerosis.
Atherosclerotic plaques are the hallmark lesion of atherosclerosis.While some plaques remain asymptomatic, some become obstructive causing stable angina, and others elicit acute thrombosis which may lead to an acute coronary syndrome.7,8
This section provides more information about the pathological features of vulnerable plaques and the effect of LDL-C lowering on features of plaque stability.
The risk for CV events is related to cumulative exposure and magnitude of LDL-C levels.9-11
Evidence from randomized clinical trials and genetic studies demonstrate that reduction in CV risk is proportional to the absolute reduction in LDL-C levels.1,12-14
Learn more about the regulation of circulating cholesterol levels and the role of PCSK9 by watching the video in this section.
Check out this interactive artery showing the progression of atherosclerosis and vulnerable plaque.
Real-world studies consistently demonstrate that the majority of patients with ASCVD at high risk for further CV events do not achieve the recommended LDL-C levels set by current guidelines.1, 9,10
Continue reading to learn more about LDL-C level attainment in the real world.
In the USA, CVD is a leading cause of morbidity, with heart disease, stroke, and hypertension ranking among the top causes of morbidity. In addition, 1 in 3 patients with established ASCVD (either MI or stroke) remain at risk for subsequent events.15,16
Learn more about the risk of recurrent events in patients with ASCVD.
Current guidelines recognize that lower is better for patients with ASCVD when it comes to LDL-C reduction, as achieving lower LDL-C levels over time results in further reduction in CV risk.17-19
This section provides an overview of LDL-C thresholds and the current guideline recommendations, as well as additional information on treatment targets, in very high-risk patients.
Read the latest 2022 Expert Consensus Decision Pathway on the role of non-statin therapies for LDL-C lowering in the management of ASCVD risk.