Lower LDL target beneficial after stroke

I suppose I should look into my medical records and see what my LDL is. 

Lower LDL target beneficial after stroke

Pierre Amarenco

PHILADELPHIA — Among patients with signs of atherosclerosis following stroke or transient ischemic attack, those who achieved a target LDL level of less than 70 mg/dL had lower risk for subsequent CV events than patients achieving LDL levels between 90 and 110 mg/dL, according to findings presented at the American Heart Association Scientific Sessions.
In the Treat Stroke to Target trial of 2,860 patients with stroke or TIA (mean LDL at baseline, 135 mg/dL), those assigned to a regimen to treat LDL level to a target of < 70 mg/dL had a lower incidence of the primary endpoint of subsequent stroke, MI, urgent revascularization, or CV death at a median follow-up of 3.5 years compared with patients assigned a regimen to achieve LDL 90 mg/dL to 110 mg/dL (adjusted HR = 0.78; 95% CI, 0.61-0.98).

The primary endpoint occurred in 8.5% of the lower-target group, which achieved a mean LDL of 65 mg/dL, and in 10.9% of the higher-target group, which achieved a mean LDL of 98 mg/dL, according to the researchers.
The findings were simultaneously published in The New England Journal of Medicine.
The trial was stopped for administrative reasons after 277 of an anticipated 385 endpoint events had occurred, according to the presentation.
“With the limitation that we had to stop the trial ... it showed that after an ischemic stroke with evidence of atherosclerosis, the target LDL cholesterol of less than 70 mg/dL compared to 100 mg/dL reduces the risk of subsequent cardiovascular events,” Pierre Amarenco, MD, chairman of the department of neurology and the Stroke Center at Bichat Hospital and professor of neurology at Xavier Bichat Medical School and Denis Diderot University in Paris, said during the presentation. “We also saw no significant increase in intracranial hemorrhage or in newly diagnosed diabetes.”
Methods and limitations
In this parallel-group trial conducted in France and South Korea, all patients (mean age, 67 years; 68% men) had evidence of cerebrovascular or coronary artery atherosclerosis and received a statin and/or ezetimibe.
“The extension of the trial by the sponsor allowed follow-up for every patient until the end of the trial rather than for 3 years, as initially planned,” the researchers wrote in NEJM. “This allowed for the observed 277 events to provide a sufficient power to detect a 25% lower relative risk in the lower-target group, as hypothesized in the original trial design.”