Lowering LDL-C May Prevent Cardiovascular Disease in Asymptomatic Atherosclerosis

3d illustration of a narrowed blood vessel.
Researchers investigate whether asymptomatic atherosclerotic CVD can be prevented with an aggressive medical treatment that reduces LDL cholesterol to <60 mg/dl.

The following article is a part of conference coverage from the American Association of Clinical Endocrinology Annual Meeting 2021: ENVISION, being held virtually from May 26 to May 29, 2021. The team at Endocrinology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AACE Annual Meeting 2021: ENVISION.


Aggressive therapy to reduce low-density lipoprotein cholesterol (LDL-C) can prevent cardiovascular disease (CVD) in asymptomatic atherosclerosis, according to study results presented at the American Association of Clinical Endocrinology annual meeting, held online from May 26-29, 2021.

In this study, researchers used a coronary artery calcium scan to assess CVD risk in adults (N=156), based on the following factors: total coronary artery calcium score, duration of follow-up, and presence or absence of metabolic syndrome. Treatment with rosuvastatin 10 mg/day, ezetimibe 10 mg/day, and a low-cholesterol diet (<200 mg/day) was initiated in adults with a positive coronary artery calcium score.

Patients who did not have positive scores did not receive treatment but were followed for up to 5 years (mean follow-up, 38 months) for any CVD events.

Patients were divided into 2 groups based on their coronary artery calcium scan results; 97 patients had positive scores, and 59 had negative scores (ie, patients who had a zero-calcium score).

After following recommendations to lower LDL-C to less than 60 mg/dL, no CVD events occurred among the patients who had achieved the LDL-C goal (n=88), while 2 CVD events (myocardial infarctions) occurred among the patients who had not adhered to the prescribed intervention (n=9).

Among the patients with negative coronary artery calcium scores, no CVD events occurred during follow-up.

“The average cost for medical therapy was $161 per year, covered by most insurance programs,” the researchers noted. “This annual cost is far below the average direct costs of one cardiovascular event,” they concluded.

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Giannini J, Eaton P, Gonzales K, Fallahi I, Schade D. Prevention of cardiovascular events in asymptomatic individuals. Poster presented at: AACE Envision 2021; May 26-29, 2021; virtual.