What is the LDL cholesterol target for patients with established atherosclerotic cardiovascular disease?

• A. LDL < 70 mg/dL
• B. LDL < 100 mg/dL
• C. LDL < 130 mg/dL
• D. LDL < 50 mg/dL

Answer: (C)

Lowering LDL cholesterol aggressively in patients with established ASCVD reduces the risk of recurrent heart attack and stroke. The recommended goal is an LDL-C level below 70 mg/dL; if that level isn’t achievable, aim for at least about a 50% reduction from the baseline LDL-C. This level of LDL lowering has been shown to improve vascular outcomes in secondary prevention. To reach it, start or optimize high‑intensity statin therapy (for example, atorvastatin or rosuvastatin), and add ezetimibe if needed; if still above target, consider PCSK9 inhibitors. Targets like <100 mg/dL or <130 mg/dL are more appropriate for lower-risk scenarios, while <50 mg/dL is more aggressive and not routinely required unless additional therapies are used.