Treatment of the patient with ideal LDL cholesterol

Coronary heart disease (CHD) is the leading cause of death worldwide. Low-density lipoprotein-cholesterol (LDL-C) reduction is the corner-stone in both primary and secondary cardiovascular prevention. Use of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors (statins) has proved to reduce LDL-C levels and major coronary event risks. The benefit on cardiovascular risk reduction is greater as LDL-C lowering is greater. Cardiovascular risk remains unacceptably high, even in patients with on-target LDL-C. This paper presents a review of alternatives for both approach and therapy in patients with on-target LDL-C.